Individual provider Active NPI

Rami-James Kazim Assadi, MD

  • Neurology Physician
  • Saint Louis, MO
National Provider Identifier
1265819478
Registry record updated Oct 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
0101279022 Issued in VA
Practice address
1 Barnes Jewish Hospital PLZ
Div Neurology Stroke
Saint Louis, MO 63110-1003
Phone
(314) 362-1408
Fax
(314) 747-3342
NPI assigned
Apr 27, 2015
Last updated
Oct 6, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2026

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

Specialties & licenses 13

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 75219 MN
Neurology Physician 2084N0400X 036152111 IL
Neurology Physician 2084N0400X MD61392212 WA
Neurology Physician 2084N0400X 2019012538 MO
Neurology Physician 2084N0400X 01089193A IN
Neurology Physician 2084N0400X 0101279022 VA Primary
Neurology Physician 2084N0400X 67462 TN
Neurology Physician 2084N0400X ME159856 FL
Neurology Physician 2084N0400X 334610 LA
Vascular Neurology Physician 2084V0102X 036152111 IL
Vascular Neurology Physician 2084V0102X 01089193A IN
Vascular Neurology Physician 2084V0102X 67462 TN
Vascular Neurology Physician 2084V0102X 0101279022 VA

Addresses

Primary practice location

1 Barnes Jewish Hospital PLZ
Div Neurology Stroke
Saint Louis, MO 63110-1003

Mailing address

660 S Euclid Ave
CB 8111
Saint Louis, MO 63110-1010
Phone (314) 362-1408

Other practice location 1

1990 Holton Ave E
Big Stone Gap, VA 24219-3350
Phone (276) 523-3111

Other practice location 2

312 Hospital Dr
Clintwood, VA 24228-6786
Phone (276) 926-0300

Other practice location 3

16000 Johnston Memorial Dr
Abingdon, VA 24211-7664
Phone (276) 258-1000

Other practice location 4

130 W Ravine Rd
Kingsport, TN 37660-3837
Phone (423) 224-3150

Other practice location 5

1901 S Shady St
Mountain City, TN 37683-2021
Phone (423) 727-1100

Other practice location 6

1501 W Elk Ave
Elizabethton, TN 37643-2874
Phone (423) 542-1300

Other practice location 7

851 Locust St
Rogersville, TN 37857-2407
Phone (423) 921-7000

Other practice location 8

2801 N Gantenbein Ave
Portland, OR 97227-1623
Phone (503) 413-2200

Other practice location 9

701 Park Ave
Minneapolis, MN 55415-1623
Phone (612) 873-3000

Other practice location 10

12200 Warwick Blvd Ste 110
Newport News, VA 23601-2344
Phone (757) 534-5100

Other practice location 11

2000 Brookside Dr
Kingsport, TN 37660-4627
Phone (423) 857-7000

Other practice location 12

1519 Main St
Sneedville, TN 37869-3657
Phone (423) 733-5000

Other practice location 13

6000 Hospital Dr
Hannibal, MO 63401-6887
Phone (573) 629-3342

Other practice location 14

15790 Paul Vega Md Dr
Hammond, LA 70403-1436
Phone (985) 230-1683

Other practice location 15

245 Medical Park Dr
Marion, VA 24354-1100
Phone (276) 378-1000

Other practice location 16

1 Medical Park Blvd
Bristol, TN 37620-7430
Phone (423) 844-1121

Other practice location 17

1420 Tusculum Blvd
Greeneville, TN 37745-4279
Phone (423) 787-5000

Other practice location 18

58 Carroll Street
Lebanon, VA 24266-4510
Phone (276) 883-8000

Other practice location 19

2030 Temple Hill Rd
Erwin, TN 37650-8721
Phone (423) 743-3141

Other practice location 20

300 Med Tech Pkwy
Johnson City, TN 37604-2277
Phone (423) 302-1000

Other practice location 21

100 15th St NW
Norton, VA 24273-1616
Phone (423) 630-7001

Other practice location 22

400 N State Of Franklin Rd
Johnson City, TN 37604-6035
Phone (423) 323-6900

Other practice location 23

127 Health Care Dr
Pennington Gap, VA 24277-2853
Phone (276) 299-5000

Other identifiers 2

IdentifierTypeStateIssuer
ME159856OtherFLFLORIDA LICENSE
200077714MedicaidMO

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Washington University

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, FL, IN, MN, LA, IL, GA, CA, WA, VA, TN, MS, ME, NC, NY, OR16 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 16

Enrollment IDStateProvider typePAC IDDetails
I20200626001431 MO Practitioner - Neurology 8325343247 Reassigns benefits to 4 organizations
I20230224002217 FL Practitioner - Neurology 8325343247 Reassigns benefits to 1 organization
I20230413000733 IN Practitioner - Neurology 8325343247 Reassigns benefits to 1 organization
I20231010003699 MN Practitioner - Neurology 8325343247 Reassigns benefits to 1 organization
I20231101002890 LA Practitioner - Neurology 8325343247 Reassigns benefits to 1 organization
I20231108002019 IL Practitioner - NeurologyPractitioner - Other (Physician) 8325343247 Reassigns benefits to 1 organization
I20231211000738 GA Practitioner - Neurology 8325343247 Reassigns benefits to 1 organization
I20240130001787 CA Practitioner - Neurology 8325343247 Reassigns benefits to 2 organizations
I20240521000075 WA Practitioner - Neurology 8325343247 Reassigns benefits to 5 organizations
I20240730001000 VA Practitioner - Neurology 8325343247 Reassigns benefits to 2 organizations
I20241028000072 TN Practitioner - Neurology 8325343247 Reassigns benefits to 1 organization
I20241108003840 MS Practitioner - Neurology 8325343247 Reassigns benefits to 1 organization
I20250228001022 ME Practitioner - Neurology 8325343247 Reassigns benefits to 5 organizations
I20250312003349 NC Practitioner - Neurology 8325343247 Reassigns benefits to 2 organizations
I20250502001995 NY Practitioner - Neurology 8325343247 Reassigns benefits to 1 organization
I20251118004127 OR Practitioner - Neurology 8325343247 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
North Oaks Medical Center LLCGroup PAC ID 2466629522, 317 clinicians
Vidant Medical Group LLCGroup PAC ID 0345343893, 986 clinicians
Riverside Health SystemGroup PAC ID 3274434717, 202 clinicians
Freeman-Oak Hill Health SystemGroup PAC ID 8325942253, shared by 14 NPIs, 385 clinicians
Wellmont Medical Associates IncGroup PAC ID 8123291739, shared by 2 NPIs, 432 clinicians
Northern Inyo Healthcare DistrictGroup PAC ID 8921992090, 104 clinicians
WakemedGroup PAC ID 7315937612, 72 clinicians
Multicare Health SystemGroup PAC ID 7719899897, 2,312 clinicians
Hennepin Healthcare System IncGroup PAC ID 4789684861, 905 clinicians

Practice addresses (Care Compare)

Seattle, WA 98108
Phone (985) 230-1683

Seattle, WA 98116
Phone (612) 702-4555

105 S 1St St
Willmington, IL 60481-8973
Phone (815) 476-5210

1102 W 32 St
Joplin, MO 64804-3503
Phone (417) 347-4570

1102 W 32ND St
Suite 300
Joplin, MO 64804-3503
Phone (417) 347-5000

130 W Ravine Rd
Kingsport, TN 37660-3837
Phone (423) 230-8412

150 Pioneer LN
Bishop, CA 93514-2556
Phone (760) 873-5811

15790 Paul Vega MD Dr
Hammond, LA 70403-1434
Phone (985) 230-1683

16000 Johnson Memorial Dr
Abingdon, VA 24211-7664
Phone (276) 258-8200

2100 Stantonsburg Rd
Greenville, NC 27834-2818
Phone (252) 847-1757

3000 New Bern Ave
Raleigh, NC 27610-1231
Phone (919) 350-8000

4700 Point Fosdick Dr
Gig Harbor, WA 98335-1706

701 Park Ave
Minneapolis, MN 55415-1623
Phone (612) 873-6963

PO Box
Suite 1257
Hannibal, MO 63401-1257
Phone (573) 248-5460

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME159856FLMDNeurology Physician
334610LAMDNeurology Physician
75219MNMDNeurology Physician
2019012538MOMDNeurology Physician
67462TNMDNeurology Physician
0101279022VAMDNeurology Physician
MD61392212WAMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hannibal Regional Healthcare System Inc CurrentSince Apr 3, 2023 Accepting new patients
Hennepin Healthcare System, Inc Current Accepting new patients
Central Maine Medical Center CurrentSince Dec 6, 2024 Accepting new patients
Multicare Health System CurrentSince Mar 1, 2025 Accepting new patients
Riverside Physician Services Inc CurrentSince Jun 26, 2024 Accepting new patients
Singing River Health System CurrentSince Nov 1, 2024 Accepting new patients
Bridgton Hospital CurrentSince Dec 6, 2024 Accepting new patients
Wellmont Medical Associates Inc CurrentSince Aug 1, 2024 Accepting new patients
Wyoming County CurrentSince Feb 24, 2025 Accepting new patients
Wakemed CurrentSince Jul 28, 2025 Accepting new patients
Riverside Physician Services Inc Current Accepting new patients
Rumford Hospital CurrentSince Dec 6, 2024 Accepting new patients
Halifax Healthcare Systems Inc CurrentSince Nov 15, 2022 Accepting new patients
Wellmont Medical Associates, Inc. CurrentSince Aug 1, 2024 Accepting new patients
Hendricks County Hospital Neurology CurrentSince Feb 28, 2023 Accepting new patients
Wyoming County CurrentSince Feb 24, 2025 Accepting new patients
Riverside Health System CurrentSince Jan 7, 2025 Accepting new patients
Legacy Salmon Creek Hospital CurrentSince Sep 12, 2025 Accepting new patients
Washington University CurrentSince Jul 1, 2020 Accepting new patients
Multicare Health System CurrentSince Mar 1, 2025 Accepting new patients
Wyoming County Current Accepting new patients
Riverside Health System Current Accepting new patients
Vidant Medical Group LLC CurrentSince Nov 24, 2024 Accepting new patients
Bridgton Hospital CurrentSince Dec 6, 2024 Accepting new patients
Hendricks County Hospital Current Accepting new patients
Multicare Health System Current Accepting new patients
Silverton Health CurrentSince Sep 12, 2025 Accepting new patients
Hendricks County Hospital CurrentSince Feb 28, 2023 Accepting new patients
Central Maine Medical Center CurrentSince Dec 6, 2024 Accepting new patients
Hennepin Healthcare System Inc CurrentSince Sep 26, 2023 Accepting new patients
Centra Medical Group, LLC CurrentSince Oct 7, 2024 Accepting new patients
Silverton Health Current Accepting new patients
Northern Inyo Healthcare District CurrentSince Mar 1, 2024 Accepting new patients
Freeman-Oak Hill Health System Neurology CurrentSince May 1, 2024 Accepting new patients
Central Maine Medical Center Current Accepting new patients
Adventist Health System Georgia Inc CurrentSince Dec 1, 2023 Accepting new patients
Legacy Salmon Creek Hospital CurrentSince Sep 12, 2025 Accepting new patients
Riverside Physician Services, Inc. Neurology CurrentSince Jun 26, 2024 Accepting new patients
Hennepin Healthcare System, Inc CurrentSince Sep 26, 2023 Accepting new patients
Wellmont Health System Current Accepting new patients
Wakemed CurrentSince Jul 28, 2025 Accepting new patients
Wellmont Medical Associates Inc CurrentSince Aug 1, 2024 Accepting new patients
Wyoming County Current Accepting new patients
Silverton Health CurrentSince Sep 12, 2025 Accepting new patients
Freeman-Oak Hill Health System CurrentSince May 1, 2024 Accepting new patients
Legacy Clinics LLC CurrentSince Sep 12, 2025 Accepting new patients
Northern Inyo Healthcare District CurrentSince Mar 1, 2024 Accepting new patients
Washington University CurrentSince Jul 1, 2020 Accepting new patients
North Oaks Medical Center, LLC CurrentSince Aug 1, 2023 Accepting new patients
Rumford Hospital CurrentSince Dec 6, 2024 Accepting new patients

Locations (25 of 61)

150 Pioneer Ln
Bishop, CA 93514
Phone (760) 873-2136

303 N Clyde Morris Blvd
Daytona Beach, FL 32114
Phone (386) 425-2285

1035 Red Bud Rd NE
Calhoun, GA 30701
Phone (706) 602-7800

707 Old Dalton Ellijay Rd
Chatsworth, GA 30705
Phone (706) 517-2050

105 S First St
Wilmington, IL 60481
Phone (815) 476-5210

301 Satori Pkwy
Ste 150
Avon, IN 46123
Phone (317) 272-3662

8244 E US Highway 36
Ste 1340
Avon, IN 46123
Phone (317) 520-5510

15790 Paul Vega Md Dr
Hammond, LA 70403
Phone (985) 230-1682

10 Hospital Dr
Bridgton, ME 04009
Phone (207) 647-6000

300 Main St
Lewiston, ME 04240
Phone (207) 795-2400

300 Main St
Slp Lab
Lewiston, ME 04240
Phone (207) 795-7522

420 Franklin St
Rumford, ME 04276
Phone (207) 364-4581

701 Park Ave
Minneapolis, MN 55415
Phone (612) 873-6005

6000 Hospital Dr
Hannibal, MO 63401
Phone (573) 248-5460

6000 Hospital Dr
#1257
Hannibal, MO 63401
Phone (573) 248-5460

1102 W 32nd St
Joplin, MO 64804
Phone (417) 347-1078

1102 W 32nd St
Ste 300
Joplin, MO 64804
Phone (417) 347-5000

307 W 11th St
Lamar, MO 64759
Phone (417) 682-3300

1 Barnes Hospital Plz
Saint Louis, MO 63110
Phone (314) 362-9170

1 Barnes Jewish Hospital Plz
Saint Louis, MO 63110
Phone (314) 362-1700

4455 Duncan Ave
Saint Louis, MO 63110
Phone (314) 658-3800

660 S Euclid Ave
#8111
Saint Louis, MO 63110
Phone (314) 362-3281

2101 Highway 90
Gautier, MS 39553
Phone (228) 497-7576

3603 Bienville Blvd
Ocean Springs, MS 39564
Phone (228) 762-3000

120 Healthplex Way
Apex, NC 27502
Phone (919) 235-6525

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/4517c430-03bf-4e32-b324-1387cc4e73f3/
  • FHIR API: https://fhir.fhirpoint.open.allscripts.com/fhirroute/open/10040602
  • Direct secure messaging: rassadi430806@balladhealth.medalliesdirect.net

Organizations & group practices 50

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

View all 50

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1430092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791244800000",
    "number": "1265819478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "660 S EUCLID AVE",
            "address_2": "CB 8111",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101010",
            "telephone_number": "314-362-1408",
            "fax_number": "314-747-3342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BARNES JEWISH HOSPITAL PLZ",
            "address_2": "DIV NEUROLOGY STROKE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101003",
            "telephone_number": "314-362-1408",
            "fax_number": "314-747-3342"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1990 Holton Ave E",
            "address_purpose": "LOCATION",
            "city": "Big Stone Gap",
            "state": "VA",
            "postal_code": "242193350",
            "country_code": "US",
            "telephone_number": "276-523-3111",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "312 Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Clintwood",
            "state": "VA",
            "postal_code": "242286786",
            "country_code": "US",
            "telephone_number": "276-926-0300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "16000 Johnston Memorial Dr",
            "address_purpose": "LOCATION",
            "city": "Abingdon",
            "state": "VA",
            "postal_code": "242117664",
            "country_code": "US",
            "telephone_number": "276-258-1000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "130 W Ravine Rd",
            "address_purpose": "LOCATION",
            "city": "Kingsport",
            "state": "TN",
            "postal_code": "376603837",
            "country_code": "US",
            "telephone_number": "423-224-3150",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1901 S Shady St",
            "address_purpose": "LOCATION",
            "city": "Mountain City",
            "state": "TN",
            "postal_code": "376832021",
            "country_code": "US",
            "telephone_number": "423-727-1100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1501 W Elk Ave",
            "address_purpose": "LOCATION",
            "city": "Elizabethton",
            "state": "TN",
            "postal_code": "376432874",
            "country_code": "US",
            "telephone_number": "423-542-1300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "851 Locust St",
            "address_purpose": "LOCATION",
            "city": "Rogersville",
            "state": "TN",
            "postal_code": "378572407",
            "country_code": "US",
            "telephone_number": "423-921-7000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2801 N Gantenbein Ave",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972271623",
            "country_code": "US",
            "telephone_number": "503-413-2200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "701 Park Ave",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554151623",
            "country_code": "US",
            "telephone_number": "612-873-3000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12200 Warwick Blvd Ste 110",
            "address_purpose": "LOCATION",
            "city": "Newport News",
            "state": "VA",
            "postal_code": "236012344",
            "country_code": "US",
            "telephone_number": "757-534-5100",
            "fax_number": "757-534-5395",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2000 Brookside Dr",
            "address_purpose": "LOCATION",
            "city": "Kingsport",
            "state": "TN",
            "postal_code": "376604627",
            "country_code": "US",
            "telephone_number": "423-857-7000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1519 Main St",
            "address_purpose": "LOCATION",
            "city": "Sneedville",
            "state": "TN",
            "postal_code": "378693657",
            "country_code": "US",
            "telephone_number": "423-733-5000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6000 Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Hannibal",
            "state": "MO",
            "postal_code": "634016887",
            "country_code": "US",
            "telephone_number": "573-629-3342",
            "fax_number": "573-629-3432",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "15790 Paul Vega Md Dr",
            "address_purpose": "LOCATION",
            "city": "Hammond",
            "state": "LA",
            "postal_code": "704031436",
            "country_code": "US",
            "telephone_number": "985-230-1683",
            "fax_number": "985-230-6652",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "245 Medical Park Dr",
            "address_purpose": "LOCATION",
            "city": "Marion",
            "state": "VA",
            "postal_code": "243541100",
            "country_code": "US",
            "telephone_number": "276-378-1000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Medical Park Blvd",
            "address_purpose": "LOCATION",
            "city": "Bristol",
            "state": "TN",
            "postal_code": "376207430",
            "country_code": "US",
            "telephone_number": "423-844-1121",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1420 Tusculum Blvd",
            "address_purpose": "LOCATION",
            "city": "Greeneville",
            "state": "TN",
            "postal_code": "377454279",
            "country_code": "US",
            "telephone_number": "423-787-5000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "58 Carroll Street",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "VA",
            "postal_code": "242664510",
            "country_code": "US",
            "telephone_number": "276-883-8000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2030 Temple Hill Rd",
            "address_purpose": "LOCATION",
            "city": "Erwin",
            "state": "TN",
            "postal_code": "376508721",
            "country_code": "US",
            "telephone_number": "423-743-3141",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "300 Med Tech Pkwy",
            "address_purpose": "LOCATION",
            "city": "Johnson City",
            "state": "TN",
            "postal_code": "376042277",
            "country_code": "US",
            "telephone_number": "423-302-1000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 15th St NW",
            "address_purpose": "LOCATION",
            "city": "Norton",
            "state": "VA",
            "postal_code": "242731616",
            "country_code": "US",
            "telephone_number": "423-630-7001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "400 N State Of Franklin Rd",
            "address_purpose": "LOCATION",
            "city": "Johnson City",
            "state": "TN",
            "postal_code": "376046035",
            "country_code": "US",
            "telephone_number": "423-323-6900",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "127 Health Care Dr",
            "address_purpose": "LOCATION",
            "city": "Pennington Gap",
            "state": "VA",
            "postal_code": "242772853",
            "country_code": "US",
            "telephone_number": "276-299-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ASSADI",
        "first_name": "RAMI-JAMES",
        "middle_name": "KAZIM",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-27",
        "last_updated": "2026-10-06",
        "certification_date": "2026-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MN",
            "license": "75219",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "IL",
            "license": "036152111",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "WA",
            "license": "MD61392212",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MO",
            "license": "2019012538",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "IN",
            "license": "01089193A",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "VA",
            "license": "0101279022",
            "primary": true
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "TN",
            "license": "67462",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "FL",
            "license": "ME159856",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "LA",
            "license": "334610",
            "primary": false
        },
        {
            "code": "2084V0102X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Vascular Neurology",
            "state": "IL",
            "license": "036152111",
            "primary": false
        },
        {
            "code": "2084V0102X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Vascular Neurology",
            "state": "IN",
            "license": "01089193A",
            "primary": false
        },
        {
            "code": "2084V0102X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Vascular Neurology",
            "state": "TN",
            "license": "67462",
            "primary": false
        },
        {
            "code": "2084V0102X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Vascular Neurology",
            "state": "VA",
            "license": "0101279022",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA LICENSE",
            "identifier": "ME159856",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200077714",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "affiliationName": "Washington University",
            "address_1": "1 Barnes Jewish Hospital Plz",
            "address_2": "Div Neurology Stroke",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631101003",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.