Organization Active NPI

Gomelb Vascular Consultants LLC

  • Vascular Specialist/Technologist Cardiovascular
  • Saint Louis, MO
National Provider Identifier
1760943047
Registry record updated Apr 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Specialist/Technologist CardiovascularTaxonomy code 246XC2903X
Legal business name
GOMELB VASCULAR CONSULTANTS LLC
Practice address
3933 S Broadway
Saint Louis, MO 63118-4601
Phone
(314) 865-7000
NPI assigned
Mar 28, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2019

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

Authorized official

Name
Olaguoke Akinwande, MD
Title
Ceo
Phone
(314) 380-3099

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Specialist/Technologist CardiovascularGroup: 193200000X MULTI-SPECIALTY GROUP 246XC2903X Primary
Cardiovascular-Interventional Technology Radiologic TechnologistGroup: 193200000X MULTI-SPECIALTY GROUP 2471C1101X
Nuclear Medicine Technology Radiologic TechnologistGroup: 193200000X MULTI-SPECIALTY GROUP 2471N0900X
Vascular-Interventional Technology Radiologic TechnologistGroup: 193200000X MULTI-SPECIALTY GROUP 2471V0106X

Addresses

Primary practice location

3933 S Broadway
Saint Louis, MO 63118-4601

Mailing address

9006 Stonebridge Dr
Richmond Heights, MO 63117-1025

National Provider Directory

National Provider Directory

Locations

3933 S Broadway
Ste 240
Saint Louis, MO 63118
Phone (314) 865-7000

NPI Registry JSON

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

{
    "created_epoch": "1553731200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1555891200000",
    "number": "1760943047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9006 STONEBRIDGE DR",
            "city": "RICHMOND HEIGHTS",
            "state": "MO",
            "postal_code": "631171025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3933 S BROADWAY",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631184601",
            "telephone_number": "314-865-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOMELB VASCULAR CONSULTANTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-28",
        "last_updated": "2019-04-22",
        "status": "A",
        "authorized_official_last_name": "AKINWANDE",
        "authorized_official_first_name": "OLAGUOKE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "314-380-3099",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "246XC2903X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist/Technologist Cardiovascular, Vascular Specialist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2471C1101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiologic Technologist, Cardiovascular-Interventional Technology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2471N0900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiologic Technologist, Nuclear Medicine Technology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2471V0106X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiologic Technologist, Vascular-Interventional Technology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "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 Apr 22, 2019; 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.