Individual provider Active NPI

John A Lautenschlager, M.D.

  • Family Medicine Physician
  • Saint Louis, MO
National Provider Identifier
1649257262
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
31708 Issued in MO
Practice address
4000 Jennings Station Rd
Saint Louis, MO 63121-3323
Phone
(314) 679-7800
Fax
(314) 679-7845
NPI assigned
Dec 23, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 31708 MO Primary

Addresses

Primary practice location

4000 Jennings Station Rd
Saint Louis, MO 63121-3323

Mailing address

4590 S Lindbergh Blvd
Saint Louis, MO 63127-1810
Phone (314) 849-7669

Other identifiers 1

IdentifierTypeStateIssuer
206701302MedicaidMO

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
31708MOMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of St Louis Division of Fiscal Management Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1135296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1649257262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4590 S LINDBERGH BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631271810",
            "telephone_number": "314-849-7669",
            "fax_number": "314-849-7670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 JENNINGS STATION RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631213323",
            "telephone_number": "314-679-7800",
            "fax_number": "314-679-7845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAUTENSCHLAGER",
        "first_name": "JOHN",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-23",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "31708",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "206701302",
            "state": "MO"
        }
    ],
    "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 Jul 9, 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.

Verify at the official NPI Registry.