Vicram Gupta, MD

Primary specialty

Medical Oncology PhysicianTaxonomy code 207RX0202X

License

107588 Issued in MO

Practice address

902 N Riverside Rd
Ste 200
St Joseph, MO 64507-2559

Phone

(816) 271-1301

Fax

(816) 271-1302

NPI assigned

Mar 9, 2006

Last updated

Oct 19, 2017By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• St Joseph Oncology Inc

  • Hematology & Oncology Physician
  • Saint Joseph, MO
  • NPI 1356300735
  NPD
• Midwestern Health Management, Inc.

  • Family Medicine Physician
  • Saint Joseph, MO
  • NPI 1104962901
  NPD (past)
• St. Joseph Oncology, Inc.

  • Hematology & Oncology Physician
  • Atchison, KS
  • NPI 1891904702
  NPD (past)

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

{
    "created_epoch": "1141862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508371200000",
    "number": "1629046420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "902 N RIVERSIDE RD",
            "address_2": "STE 200",
            "city": "ST JOSEPH",
            "state": "MO",
            "postal_code": "645072559",
            "telephone_number": "816-271-1301",
            "fax_number": "816-271-1302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "902 N RIVERSIDE RD",
            "address_2": "STE 200",
            "city": "ST JOSEPH",
            "state": "MO",
            "postal_code": "645072559",
            "telephone_number": "816-271-1301",
            "fax_number": "816-271-1302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUPTA",
        "first_name": "VICRAM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-09",
        "last_updated": "2017-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "MO",
            "license": "107588",
            "primary": true
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "KS",
            "license": "0427852",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1629046420",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00859658",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF KS FOR KS LOCATIO",
            "identifier": "056938",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "21958014",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF KS FOR MO LOCATIO",
            "identifier": "704173",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100173870C",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Harris Leigh Gulledge, PARAMEDIC
• Jerry Babb Gulledge Jr., PH.D.
• William L. Gummelt, MD
• Rachel Lois Gunderson, FNP
• Sameer Gupta, MD
• Vinay Gupta, MD
• Nicholas Andrew Gutzmer, DO
• Hac, Inc (Price Chopper Pharmacy)
• Hac, Inc. (Price Chopper Pharmacy)
• Karam Hadid, DO

• Medical Oncology Physician in Saint Joseph, MO
• Providers in Saint Joseph, MO by specialty
• Medical Oncology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2017; 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.