NPIMap

Organization Active NPI

St Louis University

Doing business as SLUCare Dept of Internal Medicine-Geriatrics

  • Geriatric Medicine (Internal Medicine) Physician
  • Saint Louis, MO
National Provider Identifier
1376769380
Registry record updated Sep 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
Legal business name
ST LOUIS UNIVERSITY
Doing business as
SLUCare Dept of Internal Medicine-Geriatrics
Practice address
1225 South Grand, 2L, Door 3,4
St Louis, MO 63104
Phone
(314) 977-6100
NPI assigned
Apr 18, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2021

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

Authorized official

Name
Alyce Lanxon
Title
Executive Director
Phone
(314) 977-6828

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RG0300X Primary

Addresses

Primary practice location

1225 South Grand, 2L, Door 3,4
St Louis, MO 63104

Mailing address

3545 Lindell Blvd FL 3
Saint Louis, MO 63103-1020
Phone (314) 977-6828

Other practice location 1

3660 Vista Ave
Saint Louis, MO 63110-2540
Phone (314) 977-6055

Other names 1

  • SLUCare Dept of Internal Medicine-Geriatrics Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632182400000",
    "number": "1376769380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3545 LINDELL BLVD FL 3",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631031020",
            "telephone_number": "314-977-6828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 SOUTH GRAND, 2L, DOOR 3,4",
            "city": "ST LOUIS",
            "state": "MO",
            "postal_code": "63104",
            "telephone_number": "314-977-6100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3660 Vista Ave",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631102540",
            "country_code": "US",
            "telephone_number": "314-977-6055",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ST LOUIS UNIVERSITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-18",
        "last_updated": "2021-09-21",
        "certification_date": "2021-09-21",
        "status": "A",
        "authorized_official_last_name": "LANXON",
        "authorized_official_first_name": "ALYCE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "314-977-6828"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SLUCare Dept of Internal Medicine-Geriatrics",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "SLUCare Dept of Internal Medicine-Geriatrics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Sep 21, 2021; 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.