Missouri Endocrine & Diabetes Center, Inc.

Primary specialty

Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X

License

MDR1G71 Issued in MO

Legal business name

MISSOURI ENDOCRINE & DIABETES CENTER, INC.

Practice address

12401 Olive Blvd
Suite 207
Saint Louis, MO 63141-5448

Phone

(636) 878-5530

Fax

(314) 878-2434

NPI assigned

Mar 12, 2009

Organization subpart

No

Name

Dr. Amin Radparvar, MDNPI 1316987837

Title

Owner

Phone

(636) 939-9004

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

• Amin Radparvar, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • St Peters, MO
  • NPI 1316987837

  Endocrinology, Diabetes & Metabolism, MO

  Medicare reassignment NPD Authorized official

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Oct 30, 2014.

{
    "created_epoch": "1236816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414627200000",
    "number": "1487895074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12401 OLIVE BLVD",
            "address_2": "SUITE 207",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631415448",
            "telephone_number": "636-878-5530",
            "fax_number": "314-878-2434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12401 OLIVE BLVD",
            "address_2": "SUITE 207",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631415448",
            "telephone_number": "636-878-5530",
            "fax_number": "314-878-2434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSOURI ENDOCRINE & DIABETES CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-12",
        "last_updated": "2014-10-30",
        "status": "A",
        "authorized_official_last_name": "RADPARVAR",
        "authorized_official_first_name": "AMIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "636-939-9004",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "MO",
            "license": "MDR1G71",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Saint Louis, MO
• Endocrinology, Diabetes & Metabolism Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2014; 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.