Individual provider Active NPI

Ian McAllister Lake, DO

  • Emergency Medicine Physician
  • Saint Louis, MO
National Provider Identifier
1669177481
Registry record updated Sep 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
2026031932 Issued in MO
Practice address
1 Barnes Jewish Hospital PLZ
Saint Louis, MO 63110-1003
Phone
(314) 747-3000
Fax
(314) 405-9587
NPI assigned
Apr 3, 2023
Last updated
Sep 29, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 2026031932 MO Primary
Emergency Medicine Physician 207P00000X 036.182011 IL

Addresses

Primary practice location

1 Barnes Jewish Hospital PLZ
Saint Louis, MO 63110-1003

Mailing address

1 Barnes Jewish Hospital PLZ
Saint Louis, MO 63110-1003
Phone (314) 747-3000

Other practice location 1

525 Branson Landing Blvd
Branson, MO 65616-2052
Phone (000) 000-0000

Other practice location 2

1000 E Hwy 60
Monett, MO 65708-8258
Phone (000) 000-0000

Other practice location 3

3801 S National Ave
Springfield, MO 65807-5210
Phone (000) 000-0000

Other practice location 4

1423 N Jefferson Ave
Springfield, MO 65802-1917
Phone (000) 000-0000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231111000376 PA Order and Referring Only - Emergency MedicinePractitioner - Emergency Medicine 8426405531

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
036.182011ILMDEmergency Medicine Physician
2026031932MOMDEmergency Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1680480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790640000000",
    "number": "1669177481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 BARNES JEWISH HOSPITAL PLZ",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101003",
            "telephone_number": "314-747-3000",
            "fax_number": "314-405-9587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BARNES JEWISH HOSPITAL PLZ",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101003",
            "telephone_number": "314-747-3000",
            "fax_number": "314-405-9587"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "525 Branson Landing Blvd",
            "address_purpose": "LOCATION",
            "city": "Branson",
            "state": "MO",
            "postal_code": "656162052",
            "country_code": "US",
            "telephone_number": "000-000-0000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1000 E Hwy 60",
            "address_purpose": "LOCATION",
            "city": "Monett",
            "state": "MO",
            "postal_code": "657088258",
            "country_code": "US",
            "telephone_number": "000-000-0000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3801 S National Ave",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "MO",
            "postal_code": "658075210",
            "country_code": "US",
            "telephone_number": "000-000-0000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1423 N Jefferson Ave",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "MO",
            "postal_code": "658021917",
            "country_code": "US",
            "telephone_number": "000-000-0000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAKE",
        "first_name": "IAN",
        "middle_name": "MCALLISTER",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-04-03",
        "last_updated": "2026-09-29",
        "certification_date": "2026-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MO",
            "license": "2026031932",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036.182011",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.