Individual provider Active NPI

Kimberly A Twyman, MD

  • Pediatrics Physician
  • Saint Louis, MO
National Provider Identifier
1508942921
Registry record updated Apr 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
2009008014 Issued in MO
Practice address
1465 S Grand Blvd
Saint Louis, MO 63104-1003
Phone
(314) 268-4101
Fax
(314) 577-5379
NPI assigned
Oct 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 2009008014 MO Primary

Addresses

Primary practice location

1465 S Grand Blvd
Saint Louis, MO 63104-1003

Mailing address

PO Box 503900
Saint Louis, MO 63150-3900
Phone (314) 577-5609

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090820000880 MO Practitioner - Pediatric MedicinePractitioner - Other (Physician) 5890849186 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Hospitals East Communities CurrentSince Aug 14, 2017 Accepting new patients
SSM Cardinal Glennon Childrens Hospital Pediatrics CurrentSince Apr 7, 2017 Accepting new patients
Mercy Hospitals East Communities CurrentSince Aug 14, 2017 Accepting new patients
SSM Cardinal Glennon Children's Hospital Pediatrics CurrentSince Apr 7, 2017 Accepting new patients
Mercy East Support Services, LLC Past Accepting new patients

Locations

7344 Solutions Ctr
Chicago, IL 60677
Phone (314) 989-6189

1465 S Grand Blvd
Saint Louis, MO 63104
Phone (314) 268-4070

12680 Olive Blvd
Ste 200
Saint Louis, MO 63141
Phone (314) 251-8892

615 S New Ballas Rd
Saint Louis, MO 63141
Phone (314) 251-4687

Interoperability endpoints

  • Direct secure messaging: ktwyman954003@directc.mercy.net

Organizations & group practices 5

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": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398124800000",
    "number": "1508942921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 503900",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631503900",
            "telephone_number": "314-577-5609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1465 S GRAND BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631041003",
            "telephone_number": "314-268-4101",
            "fax_number": "314-577-5379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TWYMAN",
        "first_name": "KIMBERLY",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-27",
        "last_updated": "2014-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "2009008014",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.