Caldwell General Practice, Inc.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

R5E11 Issued in MO

Legal business name

CALDWELL GENERAL PRACTICE, INC.

Practice address

2880 Netherton Dr
Suite 103
St. Louis, MO 63136

Phone

(314) 521-7768

Fax

(314) 838-3683

NPI assigned

Jul 8, 2005

Organization subpart

No

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

Authorized official

Name

Reynal Leon Caldwell Sr., D.O.NPI 1972528750

Title

Ceo Physician

Phone

(314) 521-7768

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• General Practice Inc Former legal business name

Locations

Practitioners 2

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.

• Reynal Leon Caldwell Sr., DO

  • Family Medicine Physician
  • Saint Louis, MO
  • NPI 1972528750
  Authorized official Same address or phone
• Norma Evett Carter, FNP-BC

  • Nurse Practitioner
  • Saint Louis, MO
  • NPI 1144652850
  NPD (past)

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

{
    "created_epoch": "1120780800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1367539200000",
    "number": "1467450023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2880 NETHERTON DR",
            "address_2": "SUITE 103",
            "city": "ST. LOUIS",
            "state": "MO",
            "postal_code": "63136",
            "telephone_number": "314-521-7768",
            "fax_number": "314-838-3683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2880 NETHERTON DR",
            "address_2": "SUITE 103",
            "city": "ST. LOUIS",
            "state": "MO",
            "postal_code": "63136",
            "telephone_number": "314-521-7768",
            "fax_number": "314-838-3683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALDWELL GENERAL PRACTICE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-08",
        "last_updated": "2013-05-03",
        "status": "A",
        "authorized_official_last_name": "CALDWELL",
        "authorized_official_first_name": "REYNAL",
        "authorized_official_middle_name": "LEON",
        "authorized_official_title_or_position": "CEO PHYSICIAN",
        "authorized_official_telephone_number": "314-521-7768",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "R5E11",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "242386712",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "General Practice Inc",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Mark Caldarola, OD
• Suzanne Calder
• Sarah Marie Caldera Wimmer, LCSW
• Gianmarco Antonio Calderara, MD
• Heather N Caldieraro
• Anisha Caldwell
• Brooke Nicole Caldwell
• Cheryl A Caldwell, PT
• Jade Leanna Caldwell, RD
• Jane E Caldwell, MD

• Family Medicine Physician in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Family Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2013; 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.