Andrew Moulton, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

2023011017 Issued in MO

Practice address

1 Childrens PL, MSC 8208-0016-01
St. Louis, MO 63110

Phone

(314) 454-2527

Fax

(314) 747-8880

NPI assigned

Apr 6, 2020

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1586131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690848000000",
    "number": "1245869726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CHILDRENS PL, MSC 8208-0016-01",
            "city": "ST. LOUIS",
            "state": "MO",
            "postal_code": "63110",
            "telephone_number": "314-454-2527",
            "fax_number": "314-747-8880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CHILDRENS PL, MSC 8208-0016-01",
            "city": "ST. LOUIS",
            "state": "MO",
            "postal_code": "63110",
            "telephone_number": "314-454-2527",
            "fax_number": "314-747-8880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOULTON",
        "first_name": "ANDREW",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-06",
        "last_updated": "2023-08-01",
        "certification_date": "2023-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "VA",
            "license": "0101273926",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "2023011017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maria T Motta
• Lisa Marie Mottola Ernst, LCSW
• Danny Mou, MD
• Kathleen Moulder
• Andrea L Mouldon, PNP
• Mound City Cardiovascular Consultants, Inc.
• Mound City Inpatient Services, LLC
• Alexis Lea Mount, FNP-C
• Lauren Elizabeth Mountjoy, NP
• Wassim Mourad, MD, MHCM

• Pediatrics Physician in St. Louis, MO
• Providers in St. Louis, MO by specialty
• Pediatrics Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.