Premier Emergency Physicians, LLC

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

Legal business name

PREMIER EMERGENCY PHYSICIANS, LLC

Practice address

2345 Dougherty Ferry Rd
Saint Louis, MO 63122-3313

Phone

(314) 821-5850

Fax

(314) 966-9274

NPI assigned

Apr 27, 2006

Organization subpart

No

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

Authorized official

Name

Michael Kyle Burtnett

Title

SVP of Outpatient Services, Tenet

Phone

(469) 893-2153

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1146096000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466640000000",
    "number": "1497712103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2345 DOUGHERTY FERRY RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631223313",
            "telephone_number": "314-821-5850",
            "fax_number": "314-966-9274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2345 DOUGHERTY FERRY RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631223313",
            "telephone_number": "314-821-5850",
            "fax_number": "314-966-9274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER EMERGENCY PHYSICIANS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-27",
        "last_updated": "2016-06-23",
        "status": "A",
        "authorized_official_last_name": "BURTNETT",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "KYLE",
        "authorized_official_title_or_position": "SVP OF OUTPATIENT SERVICES, TENET",
        "authorized_official_telephone_number": "469-893-2153"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Emergency Medicine",
            "state": "MO",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500201306",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DE1476",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Emergency Medicine Physician in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Emergency Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2016; 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.