Individual provider Active NPI

Moyosoreoluwa Morenike Laditan, MBBS

  • Pediatrics Physician
  • Saint Louis, MO
National Provider Identifier
1639788029
Registry record updated May 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
2024014909 Issued in MO
Practice address
1 Childrens PL MSC 8116-0043-09
Saint Louis, MO 63110-1002
Phone
(314) 454-2341
Fax
(314) 454-2561
NPI assigned
Jul 30, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4351046257 MI
Pediatric Hematology & Oncology Physician 2080P0207X 2024014909 MO
Pediatrics Physician 208000000X 2024014909 MO Primary

Addresses

Primary practice location

1 Childrens PL MSC 8116-0043-09
Saint Louis, MO 63110-1002

Mailing address

1 Childrens PL MSC 8116-0043-09
Saint Louis, MO 63110-1002
Phone (314) 454-2341

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
4351046257MIMDInternal Medicine Physician
2024014909MOMDPediatric Hematology & Oncology Physician

NPI Registry JSON

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

{
    "created_epoch": "1596067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715040000000",
    "number": "1639788029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CHILDRENS PL MSC 8116-0043-09",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101002",
            "telephone_number": "314-454-2341",
            "fax_number": "314-454-2561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CHILDRENS PL MSC 8116-0043-09",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101002",
            "telephone_number": "314-454-2341",
            "fax_number": "314-454-2561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LADITAN",
        "first_name": "MOYOSOREOLUWA",
        "middle_name": "MORENIKE",
        "name_prefix": "Dr.",
        "credential": "MBBS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-30",
        "last_updated": "2024-05-07",
        "certification_date": "2024-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4351046257",
            "primary": false
        },
        {
            "code": "2080P0207X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Hematology-Oncology",
            "state": "MO",
            "license": "2024014909",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "2024014909",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2024; 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.