Individual provider Active NPI

Thomas Francis Byrne, M.D.

  • Emergency Medicine Physician
  • Belleville, IL
National Provider Identifier
1629164611
Registry record updated Aug 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
2012005127 Issued in MO
Practice address
4500 Memorial Dr
Belleville, IL 62226-5360
Phone
(618) 257-5879
Fax
(618) 257-6740
NPI assigned
Oct 5, 2006
Last updated
Aug 15, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 24736 WV
Emergency Medicine Physician 207P00000X 2012005127 MO Primary

Addresses

Primary practice location

4500 Memorial Dr
Belleville, IL 62226-5360

Mailing address

PO Box 7085
Jupiter, FL 33468-7085
Phone (618) 239-6565

Other practice location 1

1015 Bowles Ave
Fenton, MO 63026-2394
Phone (636) 496-2000

Other practice location 2

100 Medical Plz
Lake St Louis, MO 63367-1366
Phone (636) 625-5200

Other identifiers 1

IdentifierTypeStateIssuer
930024249OtherRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20120404000497 WV Practitioner - Emergency Medicine 8426959024 Reassigns benefits to 2 organizations
I20160823000278 FL Practitioner - Emergency Medicine 8426959024

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
24736WVMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
West Virginia University Hospitals, Inc. CurrentSince Feb 1, 2019 Accepting new patients
West Virginia University Hospitals Inc CurrentSince Feb 1, 2019 Accepting new patients
Charleston Area Medical Center Inc CurrentSince Feb 15, 2017 Accepting new patients
Charleston Area Medical Center, Inc. CurrentSince Feb 15, 2017 Accepting new patients
West Virginia University Hospitals, Inc Emergency Medicine Past Accepting new patients
Oklahoma Emergency Services PC Emergency Medicine Past Accepting new patients

Locations

501 Morris St
Charleston, WV 25301
Phone (304) 348-6293

800 Garfield Ave
Parkersburg, WV 26101
Phone (304) 420-7161

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565827200000",
    "number": "1629164611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7085",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334687085",
            "telephone_number": "618-239-6565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 MEMORIAL DR",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622265360",
            "telephone_number": "618-257-5879",
            "fax_number": "618-257-6740"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1015 Bowles Ave",
            "address_purpose": "LOCATION",
            "city": "Fenton",
            "state": "MO",
            "postal_code": "630262394",
            "country_code": "US",
            "telephone_number": "636-496-2000",
            "fax_number": "314-996-1681",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 Medical Plz",
            "address_purpose": "LOCATION",
            "city": "Lake St Louis",
            "state": "MO",
            "postal_code": "633671366",
            "country_code": "US",
            "telephone_number": "636-625-5200",
            "fax_number": "636-625-5314",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BYRNE",
        "first_name": "THOMAS",
        "middle_name": "FRANCIS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2019-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WV",
            "license": "24736",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MO",
            "license": "2012005127",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "930024249",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Belleville, IL

Sources for this page

Verify at the official NPI Registry.