NPIMap

Organization Active NPI

Woods Mill Pediatric and Adolescent Medicine, LLC

  • Pediatrics Physician
  • Chesterfield, MO
National Provider Identifier
1538374384
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
WOODS MILL PEDIATRIC AND ADOLESCENT MEDICINE, LLC
Practice address
226 S Woods Mill Rd
Suite36W
Chesterfield, MO 63017-3662
Phone
(314) 453-9666
Fax
(314) 453-9895
NPI assigned
May 14, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Kenneth C Levy, M.D.NPI 1467465443
Title
Medical Doctor
Phone
(314) 453-9666

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X MO Primary

Addresses

Primary practice location

226 S Woods Mill Rd
Suite36W
Chesterfield, MO 63017-3662

Mailing address

226 S Woods Mill Rd
Suite36W
Chesterfield, MO 63017-3662
Phone (314) 453-9666

National Provider Directory

National Provider Directory

Locations

226 S Woods Mill Rd
Ste 36W
Chesterfield, MO 63017
Phone (314) 453-9666

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1179100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1538374384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "226 S WOODS MILL RD",
            "address_2": "SUITE36W",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630173662",
            "telephone_number": "314-453-9666",
            "fax_number": "314-453-9895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "226 S WOODS MILL RD",
            "address_2": "SUITE36W",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630173662",
            "telephone_number": "314-453-9666",
            "fax_number": "314-453-9895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOODS MILL PEDIATRIC AND ADOLESCENT MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LEVY",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "MEDICAL DOCTOR",
        "authorized_official_telephone_number": "314-453-9666",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "MO",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesterfield, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.