Individual provider Active NPI

Isabelle Thala Reed South, PA

  • Physician Assistant
  • Saint Louis, MO
National Provider Identifier
1295500189
Registry record updated Aug 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2023044681 Issued in MO
Practice address
4921 Parkview PL
Div Im Endocrinology, Ste 5C
Saint Louis, MO 63110-1032
Phone
(314) 362-3500
Fax
(314) 230-1119
NPI assigned
Nov 20, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2023044681 MO Primary
Physician Assistant 363A00000X 85.010028 IL

Addresses

Primary practice location

4921 Parkview PL
Div Im Endocrinology, Ste 5C
Saint Louis, MO 63110-1032

Mailing address

4921 Parkview PL Ste 13B
Saint Louis, MO 63110-1032

Other identifiers 1

IdentifierTypeStateIssuer
220136215MedicaidMO

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
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240306001340 MO Practitioner - Physician Assistant 7810333457 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Louisiana State University School of Medicine in New Orleans, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Washington UniversityGroup PAC ID 9830008770, 2,968 clinicians

Practice addresses (Care Compare)

4921 Parkview PL
Suite 5C
Saint Louis, MO 63110-1032
Phone (314) 454-7775

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
85.010028ILMDPhysician Assistant
2023044681MOMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Washington University CurrentSince Feb 1, 2024 Accepting new patients
Washington University CurrentSince Feb 1, 2024 Accepting new patients
Washington University Past Accepting new patients

Locations

1234 S Kingshighway Blvd
Ste 1100
Saint Louis, MO 63110

4921 Parkview Pl
Ste 5C
Saint Louis, MO 63110
Phone (314) 286-2635

4921 Parkview Pl
Saint Louis, MO 63110
Phone (314) 747-4850

660 S Euclid Ave
Saint Louis, MO 63110

8 Millstone Campus Dr
Saint Louis, MO 63146
Phone (314) 273-4375

4921 Parkview Pl
Ste 13B
Saint Louis, MO 63110
Phone (314) 747-7300

Organizations & group practices 3

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": "1700438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755648000000",
    "number": "1295500189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4921 PARKVIEW PL STE 13B",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4921 PARKVIEW PL",
            "address_2": "DIV IM ENDOCRINOLOGY, STE 5C",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101032",
            "telephone_number": "314-362-3500",
            "fax_number": "314-230-1119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUTH",
        "first_name": "ISABELLE",
        "middle_name": "THALA REED",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-20",
        "last_updated": "2025-08-20",
        "certification_date": "2025-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2023044681",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "85.010028",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "220136215",
            "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": "4921 Parkview Pl",
            "address_2": "Div IM Endocrinology, Ste 5C",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631101032",
            "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.