Active NPI
Charles Richard Gulick, MD
- Obstetrics & Gynecology Physician
- Saint Louis, MO
National Provider Identifier
1700958907
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- 34749
- Practice address
- 9450 Manchester Rd
Saint Louis, MO 63119-1452 - Phone
- (314) 725-9300
- Fax
- (314) 725-4662
- NPI assigned
- Nov 14, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 34749 | MO | Primary |
Addresses
Primary practice location
9450 Manchester Rd
Saint Louis, MO 63119-1452
Mailing address
670 Mason Ridge Center Dr
Ste 300
Saint Louis, MO 63141-8573
Phone (314) 725-9300
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4122 | Other | BCBS | |
| 161803838 | Other | RAILROAD MEDICARE |
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Physician Groups LC | Obstetrics & Gynecology | 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.
-
- Multi-Specialty Clinic/Center
- Saint Louis, MO
- NPI 1285664268
Obstetrics & Gynecology
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163462400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1329696000000",
"number": "1700958907",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "670 MASON RIDGE CENTER DR",
"address_2": "STE 300",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631418573",
"telephone_number": "314-725-9300",
"fax_number": "314-725-4662"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9450 MANCHESTER RD",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631191452",
"telephone_number": "314-725-9300",
"fax_number": "314-725-4662"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GULICK",
"first_name": "CHARLES",
"middle_name": "RICHARD",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-14",
"last_updated": "2012-02-20",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "MO",
"license": "34749",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "4122",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "161803838",
"state": null
}
],
"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 Feb 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.