Individual provider Active NPI

Jerry Locheke, MD

  • Internal Medicine Physician
  • Saint Louis, MO
National Provider Identifier
1295209195
Registry record updated Jan 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2018021852 Issued in MO
Practice address
916 Olive St
Saint Louis, MO 63101-1400
Phone
(314) 436-9300
NPI assigned
Jan 14, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 14, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2018021852 MO Primary

Addresses

Primary practice location

916 Olive St
Saint Louis, MO 63101-1400

Mailing address

916 Olive St
Saint Louis, MO 63101-1400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2018021852MOMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1547424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547424000000",
    "number": "1295209195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "916 OLIVE ST",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631011400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "916 OLIVE ST",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631011400",
            "telephone_number": "314-436-9300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOCHEKE",
        "first_name": "JERRY",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-01-14",
        "last_updated": "2019-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2018021852",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2019; 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.