NPIMap

Organization Active NPI

Missouri Heart Care, LLC

  • Clinic/Center
  • Kirkwood, MO
National Provider Identifier
1417060880
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
MISSOURI HEART CARE, LLC
Practice address
525 Couch Ave
Suite 400
Kirkwood, MO 63122-5536
Phone
(314) 984-8860
NPI assigned
Aug 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Jerome Valentine Dwyer, M.D.
Title
Chief Executive Officer
Phone
(314) 984-8860

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

525 Couch Ave
Suite 400
Kirkwood, MO 63122-5536

Mailing address

525 Couch Ave
Suite 400
Kirkwood, MO 63122-5536
Phone (314) 984-8860

National Provider Directory

National Provider Directory

Locations

525 Couch Ave
Ste 400
Saint Louis, MO 63122
Phone (314) 966-8118

NPI Registry JSON

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1417060880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 COUCH AVE",
            "address_2": "SUITE 400",
            "city": "KIRKWOOD",
            "state": "MO",
            "postal_code": "631225536",
            "telephone_number": "314-984-8860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 COUCH AVE",
            "address_2": "SUITE 400",
            "city": "KIRKWOOD",
            "state": "MO",
            "postal_code": "631225536",
            "telephone_number": "314-984-8860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSOURI HEART CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DWYER",
        "authorized_official_first_name": "JEROME",
        "authorized_official_middle_name": "VALENTINE",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "314-984-8860",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kirkwood, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.