Vvasudevan LLC

Primary specialty

Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X

Legal business name

VVASUDEVAN LLC

Practice address

5401 Veterans Memorial Pkwy Ste 200
Saint Peters, MO 63376-1687

Phone

(636) 206-6022

Fax

(780) 328-3971

NPI assigned

Apr 24, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Vijaya N Vasudevan, MDNPI 1265634513

Title

Owner/Physician

Phone

(636) 206-6022

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Vijaya Nattuvetty Vasudevan, M.D.

  • Geriatric Medicine (Internal Medicine) Physician
  • Saint Peters, MO
  • NPI 1265634513
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1524528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649289600000",
    "number": "1659869857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 173",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633020173",
            "telephone_number": "314-952-8009",
            "fax_number": "888-511-1238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5401 VETERANS MEMORIAL PKWY STE 200",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633761687",
            "telephone_number": "636-206-6022",
            "fax_number": "780-328-3971"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1002 Peruque Crossing Ct Ste 101",
            "address_purpose": "LOCATION",
            "city": "O Fallon",
            "state": "MO",
            "postal_code": "633662381",
            "country_code": "US",
            "telephone_number": "636-206-6022",
            "fax_number": "780-328-3971",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "VVASUDEVAN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-24",
        "last_updated": "2022-04-07",
        "certification_date": "2022-04-07",
        "status": "A",
        "authorized_official_last_name": "VASUDEVAN",
        "authorized_official_first_name": "VIJAYA",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "636-206-6022",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine Vogel, DO
• Chad Morris Voges, MD
• Theresa A Votinelli, R.N.
• Voyager Group, Inc (Physicians Pain Clinic)
• Stephanie Renee' Vunck, M.A CF-SLP
• Hannah Elizabeth Wade, BCBA, LBA
• Erica Wagner, DPT
• Seth Allen Wagner, PHARMD
• Hunter Wagoner, PLPC
• Sydney Wahl, DMD

• Endocrinology, Diabetes & Metabolism Physician in Saint Peters, MO
• Providers in Saint Peters, MO by specialty
• Endocrinology, Diabetes & Metabolism Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.