NPIMap

Organization Active NPI

The John D. Bouhasin Center for Children With Bleeding Disorders

  • Hematology (Internal Medicine) Physician
  • St. Louis, MO
National Provider Identifier
1629525928
Registry record updated Sep 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology (Internal Medicine) PhysicianTaxonomy code 207RH0000X
Legal business name
THE JOHN D. BOUHASIN CENTER FOR CHILDREN WITH BLEEDING DISORDERS
Practice address
1465 S. Grand
St. Louis, MO 63104-1095
Phone
(314) 268-4000
NPI assigned
Sep 2, 2016
Organization subpart
Yes
Parent organization
SSM HEALTH CARDINAL GLENNON CHILDRENS HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 2, 2016

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

Authorized official

Name
Karen Rewerts
Title
Finance System VP
Phone
(314) 989-2034

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology (Internal Medicine) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RH0000X Primary

Addresses

Primary practice location

1465 S. Grand
St. Louis, MO 63104-1095

Mailing address

1465 S. Grand
St. Louis, MO 63104-1095

National Provider Directory

National Provider Directory
Tax ID family
SSM Cardinal Glennon Children'S Medical Center7 organizations share this tax ID, including this one
Part of
SSM Cardinal Glennon Children'S Medical Center

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1472774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472774400000",
    "number": "1629525928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1465 S. GRAND",
            "city": "ST. LOUIS",
            "state": "MO",
            "postal_code": "631041095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1465 S. GRAND",
            "city": "ST. LOUIS",
            "state": "MO",
            "postal_code": "631041095",
            "telephone_number": "314-268-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE JOHN D. BOUHASIN CENTER FOR CHILDREN WITH BLEEDING DISORDERS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SSM HEALTH CARDINAL GLENNON CHILDRENS HOSPITAL",
        "enumeration_date": "2016-09-02",
        "last_updated": "2016-09-02",
        "status": "A",
        "authorized_official_last_name": "REWERTS",
        "authorized_official_first_name": "KAREN",
        "authorized_official_title_or_position": "FINANCE SYSTEM VP",
        "authorized_official_telephone_number": "314-989-2034"
    },
    "taxonomies": [
        {
            "code": "207RH0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Hematology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St. Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2016; 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.