St Peters Family Medicine, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

ST PETERS FAMILY MEDICINE, LLC

Practice address

5770 Mexico Road
Ste #D
St. Peters, MO 63376-1637

Phone

(636) 926-0558

Fax

(636) 926-8141

NPI assigned

Nov 3, 2005

Last updated

Aug 19, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Talena C Hubbard

Title

Office Manager

Phone

(636) 926-0558

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1130976000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219104000000",
    "number": "1609867134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5770 MEXICO ROAD",
            "address_2": "STE #D",
            "city": "ST. PETERS",
            "state": "MO",
            "postal_code": "633761637",
            "telephone_number": "636-926-0558",
            "fax_number": "636-926-8141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5770 MEXICO ROAD",
            "address_2": "STE #D",
            "city": "ST. PETERS",
            "state": "MO",
            "postal_code": "633761637",
            "telephone_number": "636-926-0558",
            "fax_number": "636-926-8141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST PETERS FAMILY MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-03",
        "last_updated": "2008-08-19",
        "status": "A",
        "authorized_official_last_name": "HUBBARD",
        "authorized_official_first_name": "TALENA",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "636-926-0558"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Saint Peters, MO
• Providers in Saint Peters, MO by specialty
• Family Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 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.