Impact Physician Group, Missouri Pulmonary Services LLC

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

Legal business name

IMPACT PHYSICIAN GROUP, MISSOURI PULMONARY SERVICES LLC

Practice address

12380 De Paul Dr
Bridgeton, MO 63044-2511

Phone

(314) 447-9700

NPI assigned

Feb 27, 2023

Last updated

Feb 27, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Kamran R Quraishi, MDNPI 1417175068

Title

Owner

Phone

(502) 345-1561

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Michael Rush Bissette

  • Acute Care Nurse Practitioner
  • North Kansas City, MO
  • NPI 1154106268
  Medicare reassignment Care Compare group NPD
• Shiraz A Daud, M.D.

  • Pulmonary Disease Physician
  • Saint Louis, MO
  • NPI 1346206612
  Medicare reassignment Care Compare group NPD
• Robert Francis Westerheide II, ACNP

  • Acute Care Nurse Practitioner
  • Saint Louis, MO
  • NPI 1699723478
  Medicare reassignment NPD
• Kamran R Quraishi, M.D.

  • Internal Medicine Physician
  • Carmel, IN
  • NPI 1417175068
  NPD (past) Authorized official

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

{
    "created_epoch": "1677456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677456000000",
    "number": "1437858677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 EASTBROOK BND STE 218",
            "city": "PEACHTREE CITY",
            "state": "GA",
            "postal_code": "302691546",
            "telephone_number": "678-967-5599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12380 DE PAUL DR",
            "city": "BRIDGETON",
            "state": "MO",
            "postal_code": "630442511",
            "telephone_number": "314-447-9700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMPACT PHYSICIAN GROUP, MISSOURI PULMONARY SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-27",
        "last_updated": "2023-02-27",
        "certification_date": "2023-02-27",
        "status": "A",
        "authorized_official_last_name": "QURAISHI",
        "authorized_official_first_name": "KAMRAN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "502-345-1561",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Chanel Hughes
• Jessica Hutchinson, LCSW
• Amanda Michelle Huxtable, AGPCNP-C
• Joseph Ibrahim, PHARMD
• Impact Physician Group, Missouri Cardiology Services LLC
• Impact Physician Group, Missouri, LLC
• In Good Hands CDS, LLC
• Infinite Health Services
• Interventional Pain Institute LLC
• Andrea E Ivy, N.P.

• Pulmonary Disease Physician in Bridgeton, MO
• Providers in Bridgeton, MO by specialty
• Pulmonary Disease Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.