NPIMap

Individual provider Active NPI

Kimberly G Perry, D.O.

  • Emergency Medicine Physician
  • Saint Charles, MO
National Provider Identifier
1578500039
Registry record updated Jan 6, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
101732 Issued in MO
Practice address
300 1St Capitol Dr
Saint Charles, MO 63301-2844
Phone
(636) 947-5000
Fax
(636) 947-5090
NPI assigned
Jun 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 101732 MO Primary

Addresses

Primary practice location

300 1St Capitol Dr
Saint Charles, MO 63301-2844

Mailing address

1836 Lackland Hill Pkwy
Attn: Credentialing
Saint Louis, MO 63146-3572
Phone (314) 989-0300

Other identifiers 1

IdentifierTypeStateIssuer
1578500039MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
SSM Health Care St. Louis Emergency Medicine Past Accepting new patients
A T Still University of Health Sciences PastSince Oct 14, 2022 Accepting new patients
SSM Health Care St. Louis Emergency Medicine Past Accepting new patients
Physician Specialists of St Lukes LLC Emergency Medicine Past Accepting new patients
SSM St. Joseph Hospital West Emergency Medicine Past Accepting new patients
SSM Health Care St. Louis Emergency Medicine Past Accepting new patients

Organizations & group practices 6

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": "1149120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262736000000",
    "number": "1578500039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1836 LACKLAND HILL PKWY",
            "address_2": "ATTN: CREDENTIALING",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631463572",
            "telephone_number": "314-989-0300",
            "fax_number": "314-810-1399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 1ST CAPITOL DR",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633012844",
            "telephone_number": "636-947-5000",
            "fax_number": "636-947-5090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERRY",
        "first_name": "KIMBERLY",
        "middle_name": "G",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-01",
        "last_updated": "2010-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MO",
            "license": "101732",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1578500039",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Charles, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2010; 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.