Individual provider Active NPI

William B Guyol Jr., MD

  • Internal Medicine Physician
  • Saint Louis, MO
National Provider Identifier
1396738019
Registry record updated Aug 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
R2D06 Issued in MO
Practice address
1035 Bellevue Ave
Suite 105
Saint Louis, MO 63117-1854
Phone
(314) 646-7015
Fax
(314) 646-7016
NPI assigned
Aug 28, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 5, 2013

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 R2D06 MO Primary

Addresses

Primary practice location

1035 Bellevue Ave
Suite 105
Saint Louis, MO 63117-1854

Mailing address

15 York Dr
Saint Louis, MO 63144-1047
Phone (314) 432-2121

Other identifiers 1

IdentifierTypeStateIssuer
202318913MedicaidMO

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110224000979 MO Practitioner - Internal Medicine 2769663632 Practice locations: St Louis, MO

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
R2D06MOMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Harmony Healthcare, LDS, LLC Internal Medicine Current Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

1035 Bellevue Ave
Ste 105
Saint Louis, MO 63117
Phone (314) 646-7015

Organizations & group practices 2

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": "1125187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375660800000",
    "number": "1396738019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 YORK DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631441047",
            "telephone_number": "314-432-2121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1035 BELLEVUE AVE",
            "address_2": "SUITE 105",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631171854",
            "telephone_number": "314-646-7015",
            "fax_number": "314-646-7016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUYOL",
        "first_name": "WILLIAM",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-28",
        "last_updated": "2013-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "R2D06",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "202318913",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.