Individual provider Active NPI

Jeffrey M Wright, M.D.

  • Allergy Physician
  • Saint Louis, MO
National Provider Identifier
1285673715
Registry record updated May 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy PhysicianTaxonomy code 207KA0200X
License
R8A64 Issued in MO
Practice address
456 N New Ballas Rd
Ste 129
Saint Louis, MO 63141-6831
Phone
(314) 569-1881
Fax
(314) 569-3277
NPI assigned
Jun 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy Physician 207KA0200X R8A64 MO Primary
Allergy Physician 207KA0200X 036071548 IL

Addresses

Primary practice location

456 N New Ballas Rd
Ste 129
Saint Louis, MO 63141-6831

Mailing address

456 N New Ballas Rd
Ste 129
Saint Louis, MO 63141-6831
Phone (314) 569-1881

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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 1

Enrollment IDStateProvider typePAC IDDetails
I20100628000972 MO Practitioner - Allergy/Immunology 9931170545 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036071548ILMDAllergy Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Davis, Wright, Berdy, & Suffian PC CurrentSince Dec 31, 1991 Accepting new patients
Davis, Wright, Berdy & Suffian PC CurrentSince Dec 31, 1991 Accepting new patients

Locations

1 Professional Dr
Ste 150
Alton, IL 62002
Phone (618) 463-1181

456 N New Ballas Rd
Ste 129
Saint Louis, MO 63141
Phone (314) 569-1881

456 N New Ballas Rd
Ste 12
Saint Louis, MO 63141

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431302400000",
    "number": "1285673715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "456 N NEW BALLAS RD",
            "address_2": "STE 129",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631416831",
            "telephone_number": "314-569-1881",
            "fax_number": "314-569-3277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "456 N NEW BALLAS RD",
            "address_2": "STE 129",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631416831",
            "telephone_number": "314-569-1881",
            "fax_number": "314-569-3277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WRIGHT",
        "first_name": "JEFFREY",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2015-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207KA0200X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology, Allergy",
            "state": "MO",
            "license": "R8A64",
            "primary": true
        },
        {
            "code": "207KA0200X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology, Allergy",
            "state": "IL",
            "license": "036071548",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.