Individual provider Active NPI

Maimuna Baig, MD

  • General Practice Physician
  • Lake St Louis, MO
National Provider Identifier
1679536403
Registry record updated Mar 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
36225 Issued in MO
Practice address
2 Harbor Bend CT
Lake St Louis, MO 63367-1478
Phone
(636) 561-2220
Fax
(636) 625-4723
NPI assigned
Apr 11, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 26, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 36225 MO Primary

Addresses

Primary practice location

2 Harbor Bend CT
Lake St Louis, MO 63367-1478

Mailing address

2 Harbor Bend CT
Suite 202
Lake St Louis, MO 63367-1478
Phone (636) 561-2220

Other identifiers 6

IdentifierTypeStateIssuer
100766OtherMOBCBS MO PAPER CLAIMS
BA202217311MedicaidMO
S04011OtherSSM HEALTHCARE
110141833OtherPALMETTO GBA/RAILROAD MCR
18031OtherMOBCBS MO ELECTRONIC
107274OtherHEALTHLINK

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
36225MOMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ozarks Medical Center Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1144713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395792000000",
    "number": "1679536403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 HARBOR BEND CT",
            "address_2": "SUITE 202",
            "city": "LAKE ST LOUIS",
            "state": "MO",
            "postal_code": "633671478",
            "telephone_number": "636-561-2220",
            "fax_number": "636-625-4723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 HARBOR BEND CT",
            "city": "LAKE ST LOUIS",
            "state": "MO",
            "postal_code": "633671478",
            "telephone_number": "636-561-2220",
            "fax_number": "636-625-4723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAIG",
        "first_name": "MAIMUNA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-04-11",
        "last_updated": "2014-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MO",
            "license": "36225",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MO PAPER CLAIMS",
            "identifier": "100766",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "BA202217311",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SSM HEALTHCARE",
            "identifier": "S04011",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA/RAILROAD MCR",
            "identifier": "110141833",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MO ELECTRONIC",
            "identifier": "18031",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "107274",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake St Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2014; 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.