Dr. Genova, LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

R3C40 Issued in MO

Legal business name

DR. GENOVA, LLC

Practice address

5551 Winghaven Blvd
Suite 132
O Fallon, MO 63368-3617

Phone

(636) 695-2520

Fax

(636) 695-2526

NPI assigned

Oct 13, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Gregory P Genova, MD

Title

Physician

Phone

(636) 695-2520

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1699865576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5551 WINGHAVEN BLVD",
            "address_2": "SUITE 132",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633683617",
            "telephone_number": "636-695-2520",
            "fax_number": "636-695-2526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5551 WINGHAVEN BLVD",
            "address_2": "SUITE 132",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633683617",
            "telephone_number": "636-695-2520",
            "fax_number": "636-695-2526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. GENOVA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GENOVA",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "636-695-2520",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "R3C40",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in O Fallon, MO
• Providers in O Fallon, MO by specialty
• Internal Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.