Michael Gerard Guignon Sr., MD

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

036075467 Issued in IL

Practice address

4550 Memorial Dr
Ste. 280
Belleville, IL 62226

Phone

(618) 277-3109

Fax

(618) 277-3143

NPI assigned

Oct 10, 2006

Last updated

Mar 7, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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

• Ca Group LLC

  • Cardiovascular Disease Physician
  • Belleville, IL
  • NPI 1689997280
  NPD (past)
• Urology of St. Louis, Inc.

  • Urology Physician
  • Fairview Heights, IL
  • NPI 1528901287
  NPD (past)

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1700973674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4550 MEMORIAL DR",
            "address_2": "STE. 280",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "62226",
            "telephone_number": "618-277-3109",
            "fax_number": "618-277-3143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4550 MEMORIAL DR",
            "address_2": "STE. 280",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "62226",
            "telephone_number": "618-277-3109",
            "fax_number": "618-277-3143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUIGNON",
        "first_name": "MICHAEL",
        "middle_name": "GERARD",
        "name_suffix": "Sr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "IL",
            "license": "036075467",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "R2D91",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036075467",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tatyania Jamese Griffin, RBT
• Joseph Edward Gross, D.M.D.
• Group Interventions
• Susan Jacqueline Grumbine, LAC
• Courtney M Guebert, PA-C
• Lauren Gunter, LCSW
• Adam Joseph Guss
• Frederick Gustave, DDS
• Corrina M Guthrie, PTA, ATC
• Virgilio T Guzman, MD

• Urology Physician in Belleville, IL
• Providers in Belleville, IL by specialty
• Urology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.