NPIMap

Organization Active NPI

David N. Pfohl, MD, LLC

Doing business as dba ELDERMED SERVICES

  • Geriatric Medicine (Internal Medicine) Physician
  • O'Fallon, IL
National Provider Identifier
1730190018
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
Legal business name
DAVID N. PFOHL, MD, LLC
Doing business as
dba ELDERMED SERVICES
Practice address
1512 N Green Mount Rd
Suite 200
O Fallon, IL 62269-1953
Phone
(618) 624-1860
Fax
(618) 624-1863
NPI assigned
Aug 11, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Jerrie K Weith, FHFMA
Title
Business Advisor
Phone
(618) 779-5508

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0300X Primary

Addresses

Primary practice location

1512 N Green Mount Rd
Suite 200
O Fallon, IL 62269-1953

Mailing address

PO Box 968
O Fallon, IL 62269-0968
Phone (618) 624-1860

Other names 1

  • dba ELDERMED SERVICES Doing business as

National Provider Directory

National Provider Directory

Locations

1512 N Green Mount Rd
Ste 200
O Fallon, IL 62269
Phone (618) 624-1860

Practitioners & affiliated clinicians

Practitioners 2

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": "1155254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1730190018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 968",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622690968",
            "telephone_number": "618-624-1860",
            "fax_number": "618-624-1863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1512 N GREEN MOUNT RD",
            "address_2": "SUITE 200",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622691953",
            "telephone_number": "618-624-1860",
            "fax_number": "618-624-1863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID N. PFOHL, MD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WEITH",
        "authorized_official_first_name": "JERRIE",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "BUSINESS ADVISOR",
        "authorized_official_telephone_number": "618-779-5508",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "FHFMA"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "dba ELDERMED SERVICES",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in O'Fallon, IL

Sources for this page

  • 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.