Philip Andre' St. Raymond, MD

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

14335 Issued in AZ

Practice address

1720 Mesquite Ave
Suite 100B
Lake Havasu City, AZ 86403-5602

Phone

(928) 453-1800

Fax

(928) 453-1625

NPI assigned

Sep 13, 2006

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

Enrolled in AZ

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/3014/brand/1/csg/1/fhir/r4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Philip a St Raymond MD PLLC

  • Urology Physician
  • Lake Havasu City, AZ
  • NPI 1629370580
  NPD Authorized official
• Philip a St Raymond MD PLLC

  • Urology Physician
  • Parker, AZ
  • NPI 1043556293
  NPD (past) Authorized official

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408492800000",
    "number": "1609971076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1710",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864051710",
            "telephone_number": "928-453-1800",
            "fax_number": "928-453-1625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1720 MESQUITE AVE",
            "address_2": "SUITE 100B",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864035602",
            "telephone_number": "928-453-1800",
            "fax_number": "928-453-1625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ST. RAYMOND",
        "first_name": "PHILIP",
        "middle_name": "ANDRE'",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-13",
        "last_updated": "2014-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "AZ",
            "license": "14335",
            "primary": true
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "VA",
            "license": "0101040640",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Southwest Surgery, L.L.C.
• Southwest Surgery, LLC
• Rian William Spear, PHARMD
• Peter Walmy St Louis Angervil
• Yvonne St. John, RN
• Stability Mobilized, LLC
• Michael James Stagner, MD
• June Staley, PMHNP
• Statewide Express
• Caroline Steele

• Urology Physician in Lake Havasu City, AZ
• Providers in Lake Havasu City, AZ by specialty
• Urology Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.