Individual provider Active NPI

Thomas F Musich, M.D.

  • Family Medicine Physician
  • St. Louis, MO
National Provider Identifier
1649260712
Registry record updated Jun 18, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
R7857 Issued in MO
Practice address
12700 Southfork Road
Suite 250
St. Louis, MO 63128-3286
Phone
(314) 842-0112
Fax
(314) 842-5505
NPI assigned
Oct 28, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 18, 2009

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 R7857 MO Primary

Addresses

Primary practice location

12700 Southfork Road
Suite 250
St. Louis, MO 63128-3286

Mailing address

12700 Southfork Road
Suite 250
St. Louis, MO 63128-3286
Phone (314) 842-0112

Other identifiers 2

IdentifierTypeStateIssuer
4944OtherMOBLUE CHOICE BCBS MO
184175OtherMOBCBS OF MISSOURI

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
R7857MOMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1130457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245283200000",
    "number": "1649260712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12700 SOUTHFORK ROAD",
            "address_2": "SUITE 250",
            "city": "ST. LOUIS",
            "state": "MO",
            "postal_code": "631283286",
            "telephone_number": "314-842-0112",
            "fax_number": "314-842-5505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12700 SOUTHFORK ROAD",
            "address_2": "SUITE 250",
            "city": "ST. LOUIS",
            "state": "MO",
            "postal_code": "631283286",
            "telephone_number": "314-842-0112",
            "fax_number": "314-842-5505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUSICH",
        "first_name": "THOMAS",
        "middle_name": "F",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-28",
        "last_updated": "2009-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "R7857",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHOICE BCBS MO",
            "identifier": "4944",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MISSOURI",
            "identifier": "184175",
            "state": "MO"
        }
    ],
    "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 Jun 18, 2009; 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.