JKLM Medical, LLC

Primary specialty

Phlebology PhysicianTaxonomy code 202K00000X

Legal business name

JKLM MEDICAL, LLC

Practice address

11144 Tesson Ferry Rd Ste 100
Saint Louis, MO 63123-6965

Phone

(314) 842-1441

Fax

(314) 842-1439

NPI assigned

Jun 4, 2019

Last updated

Jun 4, 2019By 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

Janelle Sheen

Title

President

Phone

(314) 842-1441

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Locations

Practitioners 3

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.

• Eric H Mai, MD

  • Family Medicine Physician
  • Creve Coeur, MO
  • NPI 1477520583
  Medicare reassignment
• Vidal T Sheen, MD

  • Vascular Surgery Physician
  • Saint Louis, MO
  • NPI 1083687859

  Phlebology

  NPD
• Rachael Damask Brewer, FNP

  • Family Nurse Practitioner
  • Saint Louis, MO
  • NPI 1073718409
  NPD (past)

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

{
    "created_epoch": "1559606400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1559606400000",
    "number": "1619535762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11144 TESSON FERRY RD STE 100",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631236965",
            "telephone_number": "314-842-1441",
            "fax_number": "314-842-1439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11144 TESSON FERRY RD STE 100",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631236965",
            "telephone_number": "314-842-1441",
            "fax_number": "314-842-1439"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "456 N New Ballas Rd Ste 126",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631416812",
            "country_code": "US",
            "telephone_number": "314-842-1441",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "JKLM MEDICAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-04",
        "last_updated": "2019-06-04",
        "status": "A",
        "authorized_official_last_name": "SHEEN",
        "authorized_official_first_name": "JANELLE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "314-842-1441"
    },
    "taxonomies": [
        {
            "code": "202K00000X",
            "taxonomy_group": "",
            "desc": "Phlebology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pawina Jiramongkolchai, MD
• Fnu Jitidhar, MD
• Sahas Reddy Jitta
• Jjea Adult Day Services, LLC
• Jjjohnsondds PC
• JMJ Medical Enterprise, LLC (JMJ Medical)
• JN Rubin, LLC
• JN Wellness Inc
• Madhura G Joag, MD
• Pricilla Joanis

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.