Active NPI
Thomas F Musich, M.D.
- Family Medicine Physician
- St. Louis, MO
National Provider Identifier
1649260712
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- R7857
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4944 | Other | MO | BLUE CHOICE BCBS MO |
| 184175 | Other | MO | BCBS 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
| License | State | Type | Specialty |
|---|---|---|---|
| R7857 | MO | MD | Family 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.