Active NPI
Josiah O Ekunno
- Gynecology Physician
- Saint Louis, MO
National Provider Identifier
1467549329
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gynecology Physician
- License
- 35803
- Practice address
- 11125 Dunn Road
Suite 202
Saint Louis, MO 63136 - Phone
- (314) 355-6218
- Fax
- (314) 355-1092
- NPI assigned
- Oct 10, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Gynecology Physician | 207VG0400X | 35803 | MO | Primary |
Addresses
Primary practice location
11125 Dunn Road
Suite 202
Saint Louis, MO 63136
Mailing address
PO Box 410858
Saint Louis, MO 63141
Phone (314) 355-6218
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200927101 | 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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35803 | MO | MD | Gynecology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160438400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1278892800000",
"number": "1467549329",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 410858",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "63141",
"telephone_number": "314-355-6218",
"fax_number": "314-355-1092"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11125 DUNN ROAD",
"address_2": "SUITE 202",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "63136",
"telephone_number": "314-355-6218",
"fax_number": "314-355-1092"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EKUNNO",
"first_name": "JOSIAH",
"middle_name": "O",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-10",
"last_updated": "2010-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "207VG0400X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology, Gynecology",
"state": "MO",
"license": "35803",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200927101",
"state": "MO"
}
],
"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 Jul 12, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.