Van A Hargraves, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

107781 Issued in MO

Practice address

5551 Winghaven Blvd
Suite 142
O Fallon, MO 63368-3617

Phone

(636) 695-2510

Fax

(636) 695-2512

NPI assigned

Sep 14, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Cardiothoracic Surgery, LLC

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  • Chesterfield, MO
  • NPI 1104895812
  NPD (past)

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

{
    "created_epoch": "1126656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478044800000",
    "number": "1255326385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 MARTIN LUTHER KING JR WAY",
            "address_2": "SUITE 142",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984054234",
            "telephone_number": "253-530-8080",
            "fax_number": "253-530-8099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5551 WINGHAVEN BLVD",
            "address_2": "SUITE 142",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633683617",
            "telephone_number": "636-695-2510",
            "fax_number": "636-695-2512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARGRAVES",
        "first_name": "VAN",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-14",
        "last_updated": "2016-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "107781",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD60598761",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "080177925",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mitchell Hammack, DPT
• Emily Suzanne Hammer, WHNP-BC
• Hammond Counseling Services LLC
• Mariah Hammond, RD
• Lauren Marie Hanson, RN, BSN, BSHC,HNB-BC
• Katherine Seiler Harkess, M.D.
• Jean Marie Harmon, M. ED., LPC
• Harmony Comprehensive Care Services LLC
• Danielle Marie Harper
• Jane A Harrer

• Family Medicine Physician in O'Fallon, MO
• Providers in O'Fallon, MO by specialty
• Family Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2016; 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.