Jason Thomas Maynes, MD/PHD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

2006024353 Issued in MO

Practice address

1 Childrens PL # 3S34
Saint Louis, MO 63110-1002

Phone

(314) 454-6006

Fax

(314) 454-4102

NPI assigned

Jan 18, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1200614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214870400000",
    "number": "1578749644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "660 S EUCLID AVE # 8033",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101010",
            "telephone_number": "314-747-4479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CHILDRENS PL # 3S34",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101002",
            "telephone_number": "314-454-6006",
            "fax_number": "314-454-4102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYNES",
        "first_name": "JASON",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "MD/PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-01-18",
        "last_updated": "2008-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "2006024353",
            "primary": true
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MO",
            "license": "2006024353",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lakeesha Mayfield, LPN
• Mary Elizabeth Mayfield, PHARMD
• Adam P Mayhew, R.N.
• Gabrielle Maynard, NP
• Nicolas Katkhordeh Maynard, MD
• Melanie M Maynor, LCSW
• Peter Maynor, MAC, LPC
• Andrew Mayo, M.D.
• Chelsea B Mayo, LPC
• Kalen Brune Mayo

• Pediatrics Physician in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Pediatrics Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2008; 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.