Active NPI
Robert J Hoffman, MD
- Pediatrics Physician
- Saint Charles, MO
National Provider Identifier
1417910191
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- R7733
- Practice address
- 11 Garvey Pkwy
Saint Charles, MO 63303-5614 - Phone
- (636) 441-7280
- Fax
- (636) 939-9208
- NPI assigned
- Apr 11, 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | R7733 | MO | Primary |
Addresses
Primary practice location
11 Garvey Pkwy
Saint Charles, MO 63303-5614
Mailing address
11 Garvey Pkwy
Saint Charles, MO 63303-5614
Phone (636) 441-7280
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417910191 | Medicaid | MO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R7733 | MO | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144713600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1516752000000",
"number": "1417910191",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11 GARVEY PKWY",
"city": "SAINT CHARLES",
"state": "MO",
"postal_code": "633035614",
"telephone_number": "636-441-7280",
"fax_number": "636-939-9208"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11 GARVEY PKWY",
"city": "SAINT CHARLES",
"state": "MO",
"postal_code": "633035614",
"telephone_number": "636-441-7280",
"fax_number": "636-939-9208"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOFFMAN",
"first_name": "ROBERT",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-11",
"last_updated": "2018-01-24",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MO",
"license": "R7733",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1417910191",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Saint Charles, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.