NPIMap

Organization Active NPI

Crestview Medical Associates, LLC

  • Internal Medicine Physician
  • Lake St Louis, MO
National Provider Identifier
1750351581
Registry record updated Sep 28, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
207R0000X Issued in MO
Legal business name
CRESTVIEW MEDICAL ASSOCIATES, LLC
Practice address
107 Brevco PLZ
Lake St Louis, MO 63367-1399
Phone
(636) 561-8100
Fax
(636) 561-3396
NPI assigned
Jan 24, 2006
Last updated
Sep 28, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2007

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

Authorized official

Name
Paul Barto Vatterott, M.D.NPI 1346239381
Title
Owner
Phone
(636) 561-8100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 207R0000X MO Primary

Addresses

Primary practice location

107 Brevco PLZ
Lake St Louis, MO 63367-1399

Mailing address

107 Brevco PLZ
Lake St Louis, MO 63367-1399
Phone (636) 561-8100

National Provider Directory

National Provider Directory

Locations

1538 Woodlake Dr
Chesterfield, MO 63017
Phone (314) 434-1600

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": "1138060800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190937600000",
    "number": "1750351581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 BREVCO PLZ",
            "city": "LAKE ST LOUIS",
            "state": "MO",
            "postal_code": "633671399",
            "telephone_number": "636-561-8100",
            "fax_number": "636-561-3396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 BREVCO PLZ",
            "city": "LAKE ST LOUIS",
            "state": "MO",
            "postal_code": "633671399",
            "telephone_number": "636-561-8100",
            "fax_number": "636-561-3396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRESTVIEW MEDICAL ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-24",
        "last_updated": "2007-09-28",
        "status": "A",
        "authorized_official_last_name": "VATTEROTT",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "BARTO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "636-561-8100",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "207R0000X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake St Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2007; 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.