Organization Active NPI

Premier U Telemed

  • Internal Medicine Physician
  • Saint Louis, MO
National Provider Identifier
1679376479
Registry record updated Mar 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
PREMIER U TELEMED
Practice address
5126 Crosswood Dr
Saint Louis, MO 63129-2450
Phone
(314) 546-6060
NPI assigned
Mar 28, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2025

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

Authorized official

Name
Brandon Williams
Title
Owner
Phone
(314) 546-6060

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

5126 Crosswood Dr
Saint Louis, MO 63129-2450

Mailing address

5126 Crosswood Dr
Saint Louis, MO 63129-2450
Phone (314) 546-6060

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1743120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1743120000000",
    "number": "1679376479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5126 CROSSWOOD DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631292450",
            "telephone_number": "314-546-6060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5126 CROSSWOOD DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631292450",
            "telephone_number": "314-546-6060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER U TELEMED",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-28",
        "last_updated": "2025-03-28",
        "certification_date": "2025-03-28",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "BRANDON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "314-546-6060"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Mar 28, 2025; 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.