NPIMap

Organization Active NPI

Premier Medical Specialists, LLC

  • Internal Medicine Physician
  • Saint Louis, MO
National Provider Identifier
1558542506
Registry record updated Jun 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
PREMIER MEDICAL SPECIALISTS, LLC
Practice address
2345 Dougherty Ferry Rd
Saint Louis, MO 63122-3313
Phone
(314) 821-5850
NPI assigned
Nov 19, 2007
Last updated
Jun 17, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2011

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

Authorized official

Name
Joe Jensen
Title
Administrator
Phone
(314) 821-5850

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X Primary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X

Addresses

Primary practice location

2345 Dougherty Ferry Rd
Saint Louis, MO 63122-3313

Mailing address

2345 Dougherty Ferry Rd
Saint Louis, MO 63122-3313
Phone (314) 821-5850

Other identifiers 2

IdentifierTypeStateIssuer
DO9596OtherMORR MEDICARE
1558542506MedicaidMO

National Provider Directory

National Provider Directory

Locations

2325 Dougherty Ferry Rd
Ste 102
Saint Louis, MO 63122
Phone (314) 965-0017

2355 Dougherty Ferry Rd
Ste 320
Saint Louis, MO 63122
Phone (314) 682-3630

3338 Watson Rd
Saint Louis, MO 63139
Phone (314) 347-0554

5898 Eichelberger St
St Louis, MO 63109
Phone (314) 832-3135

13995 Clayton Rd
Twn and Cntry, MO 63017
Phone (636) 227-5070

Practitioners & affiliated clinicians

Practitioners 7

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": "1195430400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1308268800000",
    "number": "1558542506",
    "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"
        },
        {
            "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"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER MEDICAL SPECIALISTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-19",
        "last_updated": "2011-06-17",
        "status": "A",
        "authorized_official_last_name": "JENSEN",
        "authorized_official_first_name": "JOE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "314-821-5850"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "DO9596",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1558542506",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2011; 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.