NPIMap

Organization Active NPI

Institute of Personalized Medicine LLC

  • Neurological Surgery Physician
  • Clayton, MO
National Provider Identifier
1407314263
Registry record updated Mar 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
Legal business name
INSTITUTE OF PERSONALIZED MEDICINE LLC
Practice address
7721 Clayton Rd
Clayton, MO 63117-1301
Phone
(314) 546-6072
Fax
(314) 569-4961
NPI assigned
Mar 11, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2019

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

Authorized official

Name
Terrence Chavis
Title
Owner
Phone
(314) 546-6072

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207T00000X Primary

Addresses

Primary practice location

7721 Clayton Rd
Clayton, MO 63117-1301

Mailing address

7721 Clayton Rd
Clayton, MO 63117-1301
Phone (314) 546-6072

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1552262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1552262400000",
    "number": "1407314263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7721 CLAYTON RD",
            "city": "CLAYTON",
            "state": "MO",
            "postal_code": "631171301",
            "telephone_number": "314-546-6072",
            "fax_number": "314-569-4961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7721 CLAYTON RD",
            "city": "CLAYTON",
            "state": "MO",
            "postal_code": "631171301",
            "telephone_number": "314-546-6072",
            "fax_number": "314-569-4961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INSTITUTE OF PERSONALIZED MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-11",
        "last_updated": "2019-03-11",
        "status": "A",
        "authorized_official_last_name": "CHAVIS",
        "authorized_official_first_name": "TERRENCE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "314-546-6072"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Neurological Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clayton, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2019; 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.