Organization Active NPI

West County Radiological Group, Inc.

  • Diagnostic Radiology Physician
  • Saint Louis, MO
National Provider Identifier
1477500585
Registry record updated Jul 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
WEST COUNTY RADIOLOGICAL GROUP, INC.
Practice address
615 S New Ballas Rd
Dept of Radiology
Saint Louis, MO 63141-8221
Phone
(314) 251-6031
Fax
(314) 991-8206
NPI assigned
May 27, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2022

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

Authorized official

Name
Dr. Jeffrey L. Thomasson, M.D.NPI 1548224132
Title
President
Phone
(314) 991-8200

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Nuclear Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207U00000X
Neuroradiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085N0700X
Pediatric Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085P0229X
Radiation Oncology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0001X
Diagnostic Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0202X Primary
Vascular & Interventional Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0204X

Addresses

Primary practice location

615 S New Ballas Rd
Dept of Radiology
Saint Louis, MO 63141-8221

Mailing address

11475 Olde Cabin Rd
Suite 200
Saint Louis, MO 63141-7129
Phone (314) 991-8200

Other identifiers 1

IdentifierTypeStateIssuer
500055929MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, IL, FL, NV, OK, WA, AL, NM, MI, CA, NY, TX, DC, VA, OH16 enrollments

Enrollment records 16

Enrollment IDStateProvider typePAC IDDetails
O20031223000255 MO Part B Supplier - Clinic/Group Practice 8527966944 Receives reassigned benefits from 93 practitioners
Practice locations: Washington, MO; Troy, MO; Labadie, MO; Columbia, MO
O20040326000180 MO Part B Supplier - Clinic/Group Practice 8527966944 Receives reassigned benefits from 88 practitioners
O20170130001295 IL Part B Supplier - Clinic/Group Practice 8527966944 Receives reassigned benefits from 11 practitioners
Practice locations: Maryville, IL
O20220521000405 FL Part B Supplier - Clinic/Group Practice 8527966944 Receives reassigned benefits from 2 practitioners
Practice locations: Clearwater Beach, FL; Wellington, FL
O20220810000223 NV Part B Supplier - Clinic/Group Practice 8527966944 Receives reassigned benefits from 1 practitioner
Practice locations: Reno, NV
O20221102001399 OK Part B Supplier - Clinic/Group Practice 8527966944 Receives reassigned benefits from 3 practitioners
Practice locations: Marietta, OK; Wynnewood, OK; Tishomingo, OK; Oklahoma City, OK; Healdton, OK; Edmond, OK; Ardmore, OK; Ada, OK
O20221201001650 WA Part B Supplier - Clinic/Group Practice 8527966944 Receives reassigned benefits from 2 practitioners
Practice locations: Seattle, WA; Tacoma, WA
O20230821002331 AL Part B Supplier - Clinic/Group Practice 8527966944 Receives reassigned benefits from 1 practitioner
Practice locations: Birmingham, AL
O20230929000686 NM Part B Supplier - Clinic/Group Practice 8527966944 Receives reassigned benefits from 1 practitioner
Practice locations: Albuquerque, NM
O20231107000977 MI Part B Supplier - Clinic/Group Practice 8527966944 Receives reassigned benefits from 2 practitioners
Practice locations: Ann Arbor, MI; Northville, MI
O20240314001242 CA Part B Supplier - Clinic/Group Practice 8527966944 Receives reassigned benefits from 2 practitioners
Practice locations: La Jolla, CA; Palo Alto, CA
O20240522001448 NY Part B Supplier - Clinic/Group Practice 8527966944 Receives reassigned benefits from 1 practitioner
Practice locations: New York, NY
O20240822004625 TX Part B Supplier - Clinic/Group Practice 8527966944 Receives reassigned benefits from 1 practitioner
Practice locations: The Hills, TX
O20240827003400 DC Part B Supplier - Clinic/Group Practice 8527966944 Receives reassigned benefits from 1 practitioner
Practice locations: Vienna, VA
O20250430003443 VA Part B Supplier - Clinic/Group Practice 8527966944 Receives reassigned benefits from 1 practitioner
Practice locations: Suffolk, VA; Virginia Beach, VA
O20250611000528 OH Part B Supplier - Clinic/Group Practice 8527966944 Receives reassigned benefits from 1 practitioner
Practice locations: Columbus, OH

National Provider Directory

National Provider Directory

Locations

6836 State Route 162
Maryville, IL 62062
Phone (618) 277-5882

15945 Clayton Rd
Ste 100
Ballwin, MO 63011
Phone (636) 256-5150

15945 Clayton Rd
Ste 110
Ballwin, MO 63011
Phone (636) 256-5300

1350 US Highway 61
Crystal Cty, MO 63028
Phone (636) 931-3655

11 Birnawoods Ln
Saint Louis, MO 63132
Phone (646) 456-3423

12700 Southfork Rd
Ste 152
Saint Louis, MO 63128
Phone (314) 525-1300

100 N Kingshighway Blvd
Saint Louis, MO 63108
Phone (314) 920-9090

12700 Southfork Rd
Ste 151
Saint Louis, MO 63128
Phone (314) 525-4700

621 S New Ballas Rd
Ste 23A
Saint Louis, MO 63141
Phone (314) 251-5678

11475 Olde Cabin Rd
Ste 200
Saint Louis, MO 63141
Phone (314) 991-8200

607 S New Ballas Rd
Ste T1275
Saint Louis, MO 63141
Phone (314) 251-6844

5800 Highlands Plaza Dr
Saint Louis, MO 63110
Phone (573) 270-0265

1208 King St
Chattanooga, TN 37403

Practitioners & affiliated clinicians

Practitioners 140

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 140

NPI Registry JSON

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

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658966400000",
    "number": "1477500585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11475 OLDE CABIN RD",
            "address_2": "SUITE 200",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631417129",
            "telephone_number": "314-991-8200",
            "fax_number": "314-991-8206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 S NEW BALLAS RD",
            "address_2": "DEPT OF RADIOLOGY",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418221",
            "telephone_number": "314-251-6031",
            "fax_number": "314-991-8206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST COUNTY RADIOLOGICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-27",
        "last_updated": "2022-07-28",
        "certification_date": "2022-07-28",
        "status": "A",
        "authorized_official_last_name": "THOMASSON",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "314-991-8200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207U00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nuclear Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085N0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Neuroradiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085P0229X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Pediatric Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Radiation Oncology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500055929",
            "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 28, 2022; 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.