Organization Active NPI

Nephrology and Hypertension Specialists, LLC

  • Nephrology Physician
  • Fenton, MO
National Provider Identifier
1730127200
Registry record updated Jan 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
NEPHROLOGY AND HYPERTENSION SPECIALISTS, LLC
Practice address
1011 Bowles Ave Ste 220
Fenton, MO 63026-2384
Phone
(636) 681-3030
Fax
(636) 326-1545
NPI assigned
Jun 4, 2006
Last updated
Jan 22, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2024

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

Authorized official

Name
John Mellas, MDNPI 1497712079
Title
Partner
Phone
(314) 842-9669

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X NU Primary

Addresses

Primary practice location

1011 Bowles Ave Ste 220
Fenton, MO 63026-2384

Mailing address

1011 Bowles Ave Ste 220
Fenton, MO 63026-2384
Phone (636) 681-3030

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041101000131 MO Part B Supplier - Clinic/Group Practice 4082501804 Receives reassigned benefits from 2 practitioners

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Locations

1011 Bowles Ave
Ste 220
Fenton, MO 63026
Phone (636) 681-3030

1027 Bellevue Ave
Ste G14
Saint Louis, MO 63117
Phone (314) 768-8475

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1149379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705881600000",
    "number": "1730127200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 BOWLES AVE STE 220",
            "city": "FENTON",
            "state": "MO",
            "postal_code": "630262384",
            "telephone_number": "636-681-3030",
            "fax_number": "636-326-1545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 BOWLES AVE STE 220",
            "city": "FENTON",
            "state": "MO",
            "postal_code": "630262384",
            "telephone_number": "636-681-3030",
            "fax_number": "636-326-1545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEPHROLOGY AND HYPERTENSION SPECIALISTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-04",
        "last_updated": "2024-01-22",
        "certification_date": "2024-01-22",
        "status": "A",
        "authorized_official_last_name": "MELLAS",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "314-842-9669",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fenton, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.