Individual provider Active NPI

Gary Harris Myers, MD

  • Neurology Physician
  • Saint Louis, MO
National Provider Identifier
1477514628
Registry record updated Oct 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
R5513 Issued in MT
Practice address
10004 Kennerly Rd
Suite 391B
Saint Louis, MO 63128-2141
Phone
(314) 843-8222
Fax
(314) 843-1662
NPI assigned
Mar 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X R5513 MT Primary

Addresses

Primary practice location

10004 Kennerly Rd
Suite 391B
Saint Louis, MO 63128-2141

Mailing address

10004 Kennerly Road
Suite 391B
St Louis, MO 63128
Phone (314) 843-8222

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

LicenseStateTypeSpecialty
R5513MTMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
SSM Health Care St. Louis Past Accepting new patients
SSM Health Care St. Louis Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1143590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317600000000",
    "number": "1477514628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10004 KENNERLY ROAD",
            "address_2": "SUITE 391B",
            "city": "ST LOUIS",
            "state": "MO",
            "postal_code": "63128",
            "telephone_number": "314-843-8222",
            "fax_number": "314-843-1662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10004 KENNERLY RD",
            "address_2": "SUITE 391B",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282141",
            "telephone_number": "314-843-8222",
            "fax_number": "314-843-1662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYERS",
        "first_name": "GARY",
        "middle_name": "HARRIS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-29",
        "last_updated": "2011-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MT",
            "license": "R5513",
            "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 Oct 3, 2011; 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.