Active NPI
Darrell Martin Pitt, D.O.
- Surgery Physician
- Bridgeton, MO
National Provider Identifier
1619953064
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- R6165
- Practice address
- 3444 McKelvey Rd
Bridgeton, MO 63044-2525 - Phone
- (314) 291-6224
- Fax
- (314) 291-7346
- NPI assigned
- Dec 19, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | R6165 | MO | Primary |
Addresses
Primary practice location
3444 McKelvey Rd
Bridgeton, MO 63044-2525
Mailing address
3444 McKelvey Rd
Bridgeton, MO 63044-2525
Phone (314) 291-6224
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R6165 | MO | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1134950400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1185408000000",
"number": "1619953064",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3444 MCKELVEY RD",
"city": "BRIDGETON",
"state": "MO",
"postal_code": "630442525",
"telephone_number": "314-291-6224",
"fax_number": "314-291-7346"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3444 MCKELVEY RD",
"city": "BRIDGETON",
"state": "MO",
"postal_code": "630442525",
"telephone_number": "314-291-6224",
"fax_number": "314-291-7346"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PITT",
"first_name": "DARRELL",
"middle_name": "MARTIN",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-19",
"last_updated": "2007-07-26",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "MO",
"license": "R6165",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bridgeton, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.