Bobby Vitaya Enkvetchakul, MD

Primary specialty

Occupational Medicine Clinic/CenterTaxonomy code 261QX0100X

License

MD113081 MO Issued in MO

Practice address

1 W 12TH St
Washington, MO 63090-4416

Phone

(636) 239-0735

Fax

(636) 239-0907

NPI assigned

Aug 30, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Missouri Occupational Medicine

  • Corporate Health Clinic/Center
  • Washington, MO
  • NPI 1972369619
  NPD Authorized official

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708473600000",
    "number": "1487764882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1275",
            "city": "WASHINGTON",
            "state": "MO",
            "postal_code": "630908275",
            "telephone_number": "636-239-0735",
            "fax_number": "636-239-0907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 W 12TH ST",
            "city": "WASHINGTON",
            "state": "MO",
            "postal_code": "630904416",
            "telephone_number": "636-239-0735",
            "fax_number": "636-239-0907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENKVETCHAKUL",
        "first_name": "BOBBY",
        "middle_name": "VITAYA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2024-02-21",
        "certification_date": "2024-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QX0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Occupational Medicine",
            "state": "MO",
            "license": "MD113081 MO",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Empac Employment Resources
• Empowered Family Health LLC
• Empowered Health, LLC
• Encouraging Hope Counseling LLC
• Donald Gerard Engemann
• Olivia Grace Erway, PA-C
• Ira Nathan Ettinger, O.D.
• Everside Health LLC Washington Health Ctr
• Exceptional Equestrians of the Missouri Valley, Inc.
• Eye Care Vision Center II Inc Erkers Kirkwood

• Occupational Medicine Clinic/Center in Washington, MO
• Providers in Washington, MO by specialty
• Occupational Medicine Clinic/Center in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2024; 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.