NPIMap

Organization Active NPI

Family Medicine of South City, LLC

  • Clinic/Center
  • Saint Louis, MO
National Provider Identifier
1609976752
Registry record updated Nov 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
FAMILY MEDICINE OF SOUTH CITY, LLC
Practice address
3915 Watson Rd
Ste 203
Saint Louis, MO 63109-1251
Phone
(314) 644-4410
Fax
(314) 646-0054
NPI assigned
Sep 25, 2006
Last updated
Nov 4, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2010

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

Authorized official

Name
Edina Karahodzic, MDNPI 1891895934
Title
Owner
Phone
(314) 644-4410

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

3915 Watson Rd
Ste 203
Saint Louis, MO 63109-1251

Mailing address

3915 Watson Rd
Ste 203
Saint Louis, MO 63109-1251
Phone (314) 644-4410

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1159142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288828800000",
    "number": "1609976752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3915 WATSON RD",
            "address_2": "STE 203",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631091251",
            "telephone_number": "314-644-4410",
            "fax_number": "314-646-0054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3915 WATSON RD",
            "address_2": "STE 203",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631091251",
            "telephone_number": "314-644-4410",
            "fax_number": "314-646-0054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY MEDICINE OF SOUTH CITY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-25",
        "last_updated": "2010-11-04",
        "status": "A",
        "authorized_official_last_name": "KARAHODZIC",
        "authorized_official_first_name": "EDINA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "314-644-4410",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 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.