Individual provider Active NPI

Aubra A Houchin, DO

  • Family Medicine Physician
  • Saint Peters, MO
National Provider Identifier
1598737819
Registry record updated Apr 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
R5C54 Issued in MO
Practice address
408 Jungermann Rd
St Peters, MO 63376-2799
Phone
(636) 449-5757
Fax
(636) 449-5750
NPI assigned
Feb 2, 2006
Last updated
Apr 24, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X R5C54 MO Primary

Addresses

Primary practice location

408 Jungermann Rd
St Peters, MO 63376-2799

Mailing address

4 Brantleigh CT
Saint Charles, MO 63301-4117
Phone (636) 947-4892

Other identifiers 11

IdentifierTypeStateIssuer
0100268OtherMOMEDICARE COMPLETE
100513OtherMOBLUECROSS BLUESHIELD MO
242530400MedicaidMO
PC10213OtherMOCIGNA
4078508OtherMOAETNA
431482544OtherMOUNITED HEALTHCARE
104866OtherMOHEALTHLINK
32396OtherMOGROUP HEALTH PLAN (GHP)
A10766OtherMOMERCY HEALTH PLANS
40514OtherMOHEALTHCARE USA
9458OtherMOBLUECROSS BLUESHIELD

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
I20080318000625 MO Practitioner - Family Practice 5193801033 Receives reassigned benefits from 2 practitioners
Practice locations: St. Peters, MO

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R5C54MOMDFamily Medicine Physician

Practitioners & affiliated clinicians

Practitioners 2

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": "1138838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208995200000",
    "number": "1598737819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 BRANTLEIGH CT",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633014117",
            "telephone_number": "636-947-4892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 JUNGERMANN RD",
            "city": "ST PETERS",
            "state": "MO",
            "postal_code": "633762799",
            "telephone_number": "636-449-5757",
            "fax_number": "636-449-5750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOUCHIN",
        "first_name": "AUBRA",
        "middle_name": "A",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-02",
        "last_updated": "2008-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "R5C54",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE COMPLETE",
            "identifier": "0100268",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD MO",
            "identifier": "100513",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "242530400",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "PC10213",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4078508",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "431482544",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "104866",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP HEALTH PLAN (GHP)",
            "identifier": "32396",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MERCY HEALTH PLANS",
            "identifier": "A10766",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHCARE USA",
            "identifier": "40514",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD",
            "identifier": "9458",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Peters, MO

Sources for this page

Verify at the official NPI Registry.