Des Peres Family Medicine PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

P00924526 Issued in MO

Legal business name

DES PERES FAMILY MEDICINE PC

Practice address

2325 Dougherty Ferry Rd
Suite 104
Saint Louis, MO 63122-3356

Phone

(314) 965-1965

Fax

(314) 965-1700

NPI assigned

Nov 24, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Demetrios V Politis, DONPI 1255417754

Title

President

Phone

(314) 965-1965

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Demetrios V Politis, DO

  • Family Medicine Physician
  • Saint Charles, MO
  • NPI 1255417754
  NPD Authorized official

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

{
    "created_epoch": "1227484800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1227484800000",
    "number": "1740435304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2325 DOUGHERTY FERRY RD",
            "address_2": "SUITE 104",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631223356",
            "telephone_number": "314-965-1965",
            "fax_number": "314-965-1700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2325 DOUGHERTY FERRY RD",
            "address_2": "SUITE 104",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631223356",
            "telephone_number": "314-965-1965",
            "fax_number": "314-965-1700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DES PERES FAMILY MEDICINE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-24",
        "last_updated": "2008-11-24",
        "status": "A",
        "authorized_official_last_name": "POLITIS",
        "authorized_official_first_name": "DEMETRIOS",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "314-965-1965",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "P00924526",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lori Derosear, D.O.
• Edward Justin Derrick, MD
• Paula Jean Deruntz, NP
• Des Peres Eye Surgery Center, LLC
• Des Peres Family Medicine
• Des Peres Healthmart Pharmacy LLC
• Des Peres Hospital
• Des Peres Hospital
• Des Peres Hospital
• Des Peres Hospital, Inc.

• Family Medicine Physician in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Family Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2008; 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.