Individual provider Active NPI

Damian Lafitte, MD

  • Pediatrics Physician
  • Warrenton, MO
National Provider Identifier
1568857027
Registry record updated Aug 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
2018016620 Issued in MO
Practice address
511 Ashland Ave Ste a
Warrenton, MO 63383
Phone
(318) 456-0543
NPI assigned
Apr 1, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 2, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 308864 LA
Student in an Organized Health Care Education/Training Program 390200000X
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X 2018016620 MO Primary

Addresses

Primary practice location

511 Ashland Ave Ste a
Warrenton, MO 63383

Mailing address

5510 Pershing Ave Apt 314
Saint Louis, MO 63112-1951
Phone (318) 294-6268

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
I20180802002643 MO Practitioner - Pediatric Medicine 0648575662 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
308864LAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
SSM Cardinal Glennon Childrens Hospital Single Specialty CurrentSince Aug 1, 2018 Accepting new patients
SSM Cardinal Glennon Children'S Hospital Single Specialty CurrentSince Aug 1, 2018 Accepting new patients
SSM Health Care St Louis Single Specialty CurrentSince Aug 1, 2018 Accepting new patients

Locations

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

1015 Bowles Ave
Fenton, MO 63026
Phone (636) 496-2000

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

1145 Corporate Lake Dr
Saint Louis, MO 63132
Phone (314) 989-6189

722 N State Highway 47
#B
Warrenton, MO 63383
Phone (636) 456-3413

511 Ashland Ave
Ste A
Warrenton, MO 63383
Phone (636) 456-0543

Interoperability endpoints

  • Direct secure messaging: dlafitte265354@direct-ehr-ssmhc.com

Organizations & group practices 3

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": "1427846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533168000000",
    "number": "1568857027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5510 PERSHING AVE APT 314",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631121951",
            "telephone_number": "318-294-6268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 ASHLAND AVE STE A",
            "city": "WARRENTON",
            "state": "MO",
            "postal_code": "63383",
            "telephone_number": "318-456-0543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAFITTE",
        "first_name": "DAMIAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-04-01",
        "last_updated": "2018-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "LA",
            "license": "308864",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "2018016620",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warrenton, MO

Sources for this page

Verify at the official NPI Registry.