Individual provider Active NPI

Steven P Pisoni, M.D.

  • Internal Medicine Physician
  • Saint Louis, MO
National Provider Identifier
1366436347
Registry record updated Mar 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
R1C15 Issued in MO
Practice address
7345 Watson Rd
Saint Louis, MO 63119-4405
Phone
(314) 752-7100
Fax
(314) 752-3284
NPI assigned
Sep 7, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2017

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 R1C15 MO Primary

Addresses

Primary practice location

7345 Watson Rd
Saint Louis, MO 63119-4405

Mailing address

7345 Watson Rd
Saint Louis, MO 63119-4405
Phone (314) 752-7100

Other identifiers 1

IdentifierTypeStateIssuer
201854700MedicaidMO

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
R1C15MOMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1126051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489449600000",
    "number": "1366436347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7345 WATSON RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631194405",
            "telephone_number": "314-752-7100",
            "fax_number": "314-752-3284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7345 WATSON RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631194405",
            "telephone_number": "314-752-7100",
            "fax_number": "314-752-3284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PISONI",
        "first_name": "STEVEN",
        "middle_name": "P",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-07",
        "last_updated": "2017-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "R1C15",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201854700",
            "state": "MO"
        }
    ],
    "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 Mar 14, 2017; 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.