NPIMap

Organization Active NPI

Digestive Disease Medical Consultants, PC

  • Gastroenterology Physician
  • Lake St Louis, MO
National Provider Identifier
1407960107
Registry record updated Mar 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
DIGESTIVE DISEASE MEDICAL CONSULTANTS, PC
Practice address
200 Brevco PLZ
Suite 208
Lake St Louis, MO 63367-2949
Phone
(636) 561-9020
Fax
(636) 561-6208
NPI assigned
Aug 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2011

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

Authorized official

Name
Dr. David H. Cort, M.D.
Title
Vice-President
Phone
(636) 561-9020

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0100X Primary

Addresses

Primary practice location

200 Brevco PLZ
Suite 208
Lake St Louis, MO 63367-2949

Mailing address

200 Brevco PLZ
Suite 208
Lake St Louis, MO 63367-2949
Phone (636) 561-9020

Other identifiers 2

IdentifierTypeStateIssuer
CC9057OtherMORAILROAD MEDICARE GROUP #
502983109MedicaidMO

National Provider Directory

National Provider Directory

Locations

226 S Woods Mill Rd
Ste 52W
Chesterfield, MO 63017
Phone (314) 434-2399

3023 N Ballas Rd
Ste 520D
Saint Louis, MO 63131
Phone (314) 569-2620

Practitioners & affiliated clinicians

Practitioners 12

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": "1155859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1301443200000",
    "number": "1407960107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 BREVCO PLZ",
            "address_2": "SUITE 208",
            "city": "LAKE ST LOUIS",
            "state": "MO",
            "postal_code": "633672949",
            "telephone_number": "636-561-9020",
            "fax_number": "636-561-6208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 BREVCO PLZ",
            "address_2": "SUITE 208",
            "city": "LAKE ST LOUIS",
            "state": "MO",
            "postal_code": "633672949",
            "telephone_number": "636-561-9020",
            "fax_number": "636-561-6208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIGESTIVE DISEASE MEDICAL CONSULTANTS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-18",
        "last_updated": "2011-03-30",
        "status": "A",
        "authorized_official_last_name": "CORT",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "VICE-PRESIDENT",
        "authorized_official_telephone_number": "636-561-9020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE GROUP #",
            "identifier": "CC9057",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "502983109",
            "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 Mar 30, 2011; 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.