Active NPI
Audrey K Montooth, MD
- Family Medicine Physician
- Saint Louis, MO
National Provider Identifier
1730132895
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 113043
- Practice address
- 1031 Bellevue Ave
Ste 300
Saint Louis, MO 63117-1818 - Phone
- (314) 647-9444
- Fax
- (314) 647-7317
- NPI assigned
- May 18, 2006
- Last updated
- Oct 3, 2012
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 113043 | MO | Primary |
Addresses
Primary practice location
1031 Bellevue Ave
Ste 300
Saint Louis, MO 63117-1818
Mailing address
PO Box 23340
Saint Louis, MO 63156-3340
Phone (314) 647-9444
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 290148 | Other | MO | GHP |
| 0102099 | Other | MO | UHC |
| 205163207 | Medicaid | MO | |
| 210862 | Other | MO | BCBS |
| 000000013907 | Other | MO | ESSENCE |
| 438069 | Other | MO | HEALTHLINK |
| 752695810MON | Other | MO | MERCY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- University of Kansas School of Med (KC/Wich/Sal), 1997
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1031 Bellevue Ave
Suite 300
Saint Louis, MO 63117-1857
Phone (314) 647-9444
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 113043 | MO | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Integra Physicians Urgent Care Centers, LLC | Past | Accepting new patients |
Interoperability endpoints
- audrey.montooth.p1@direct.essehealth.nextgenshare.com
Organizations & group practices 2
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.
-
dba Esse Health
- Internal Medicine Physician
- Saint Louis, MO
- NPI 1972559532
-
dba Des Peres Urgent Care Center
- Urgent Care Clinic/Center
- Saint Louis, MO
- NPI 1740319284
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Mercy Hospital St Louis
- General Acute Care Hospital
- Saint Louis, MO
- NPI 1427098169
-
dba Mercy St. Louis Transport Ambulance
- Land Ambulance
- Saint Louis, MO
- NPI 1881329902
Hospital
-
dba SSM Health Cardinal Glennon Children's Hospital
- General Acute Care Hospital
- Saint Louis, MO
- NPI 1336387836
-
dba SSM Health St. Mary's Hospital - St. Louis
- General Acute Care Hospital
- Saint Louis, MO
- NPI 1962572396
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147910400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1349222400000",
"number": "1730132895",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 23340",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631563340",
"telephone_number": "314-647-9444",
"fax_number": "314-647-7317"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1031 BELLEVUE AVE",
"address_2": "STE 300",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631171818",
"telephone_number": "314-647-9444",
"fax_number": "314-647-7317"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MONTOOTH",
"first_name": "AUDREY",
"middle_name": "K",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-18",
"last_updated": "2012-10-03",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MO",
"license": "113043",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GHP",
"identifier": "290148",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UHC",
"identifier": "0102099",
"state": "MO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "205163207",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "210862",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ESSENCE",
"identifier": "000000013907",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHLINK",
"identifier": "438069",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MERCY",
"identifier": "752695810MON",
"state": "MO"
}
],
"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 Oct 3, 2012; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.