NPIMap

Organization Active NPI

Missouri Cancer Care PC

  • Hematology & Oncology Physician
  • Lake St. Louis, MO
National Provider Identifier
1326107871
Registry record updated Dec 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
Legal business name
MISSOURI CANCER CARE PC
Practice address
400 Medical Plaza
Suite 100
Lake St. Louis, MO 63367
Phone
(636) 639-8620
Fax
(636) 639-8665
NPI assigned
Dec 8, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2008

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

Authorized official

Name
Linda J Vincent
Title
Administrator
Phone
(636) 639-8650

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207RH0003X Primary
Radiation Oncology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2085R0001X

Addresses

Primary practice location

400 Medical Plaza
Suite 100
Lake St. Louis, MO 63367

Mailing address

1078 Wentzville Parkway
Wentzville, MO 63385
Phone (636) 639-8644

Other identifiers 1

IdentifierTypeStateIssuer
507598704MedicaidMO

National Provider Directory

National Provider Directory

Locations

1092 Wentzville Pkwy
Wentzville, MO 63385
Phone (636) 639-8600

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228867200000",
    "number": "1326107871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1078 WENTZVILLE PARKWAY",
            "city": "WENTZVILLE",
            "state": "MO",
            "postal_code": "63385",
            "telephone_number": "636-639-8644",
            "fax_number": "636-639-8665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 MEDICAL PLAZA",
            "address_2": "SUITE 100",
            "city": "LAKE ST. LOUIS",
            "state": "MO",
            "postal_code": "63367",
            "telephone_number": "636-639-8620",
            "fax_number": "636-639-8665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSOURI CANCER CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-08",
        "last_updated": "2008-12-10",
        "status": "A",
        "authorized_official_last_name": "VINCENT",
        "authorized_official_first_name": "LINDA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "636-639-8650"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Radiology, Radiation Oncology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "507598704",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake St. Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2008; 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.