Active NPI
Lester Thomas Reese, MD
- Dermatology Physician
- St Louis, MO
National Provider Identifier
1417010331
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- R3735
- Practice address
- 522 North New Ballas Road
Suite 316
St Louis, MO 63141 - Phone
- (314) 567-5873
- Fax
- (314) 567-4040
- NPI assigned
- Dec 19, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | R3735 | MO | Primary |
Addresses
Primary practice location
522 North New Ballas Road
Suite 316
St Louis, MO 63141
Mailing address
522 North New Ballas Road
Suite 316
St Louis, MO 63141
Phone (314) 567-5873
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166486400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1417010331",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "522 NORTH NEW BALLAS ROAD",
"address_2": "SUITE 316",
"city": "ST LOUIS",
"state": "MO",
"postal_code": "63141",
"telephone_number": "314-567-5873",
"fax_number": "314-567-4040"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "522 NORTH NEW BALLAS ROAD",
"address_2": "SUITE 316",
"city": "ST LOUIS",
"state": "MO",
"postal_code": "63141",
"telephone_number": "314-567-5873",
"fax_number": "314-567-4040"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REESE",
"first_name": "LESTER",
"middle_name": "THOMAS",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "MO",
"license": "R3735",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in St Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.