NPIMap

Organization Active NPI

Northlight Development LP

  • Contractor
  • Saint Louis, MO
National Provider Identifier
1427422336
Registry record updated Nov 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ContractorTaxonomy code 171W00000X
License
26655 Issued in MO
Legal business name
NORTHLIGHT DEVELOPMENT LP
Practice address
3414 Hawthorne Blvd
Saint Louis, MO 63104-1623
Phone
(314) 773-4074
NPI assigned
Nov 17, 2015
Last updated
Nov 17, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2015

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

Authorized official

Name
Dr. Kenneth R Smith Jr., MD
Title
President
Phone
(314) 773-4074

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Contractor 171W00000X 26655 MO Primary

Addresses

Primary practice location

3414 Hawthorne Blvd
Saint Louis, MO 63104-1623

Mailing address

3414 Hawthorne Blvd
Saint Louis, MO 63104-1623
Phone (314) 773-4074

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1447718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447718400000",
    "number": "1427422336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3414 HAWTHORNE BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631041623",
            "telephone_number": "314-773-4074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3414 HAWTHORNE BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631041623",
            "telephone_number": "314-773-4074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHLIGHT DEVELOPMENT LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-17",
        "last_updated": "2015-11-17",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "314-773-4074",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "MO",
            "license": "26655",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2015; 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.