Active NPI
Kristina Plesons
- Internal Medicine Physician
- Saint Louis, MO
National Provider Identifier
1679983175
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 2014004059
- Practice address
- 1034 S Brentwood Blvd
Saint Louis, MO 63117-1223 - Phone
- (314) 721-2140
- Fax
- (314) 721-2115
- NPI assigned
- May 6, 2014
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 2014004059 | MO | Primary |
Addresses
Primary practice location
1034 S Brentwood Blvd
Saint Louis, MO 63117-1223
Mailing address
1034 S Brentwood Blvd
Saint Louis, MO 63117-1223
Phone (314) 721-2140
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
- Opted out of Medicare
- Yes, effective Jul 1, 2019 through Jul 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2014004059 | MO | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lima Memorial Joint Operating Company | 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.
-
- General Acute Care Hospital
- Lima, OH
- NPI 1336144732
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1399334400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1399334400000",
"number": "1679983175",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1034 S BRENTWOOD BLVD",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631171223",
"telephone_number": "314-721-2140",
"fax_number": "314-721-2115"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1034 S BRENTWOOD BLVD",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631171223",
"telephone_number": "314-721-2140",
"fax_number": "314-721-2115"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PLESONS",
"first_name": "KRISTINA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-05-06",
"last_updated": "2014-05-06",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MO",
"license": "2014004059",
"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 May 6, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.