Organization Active NPI

Raymond a. Brickhouse, DPM LLC

  • Durable Medical Equipment & Medical Supplies
  • Saint Louis, MO
National Provider Identifier
1780137356
Registry record updated Jul 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
2008026233 Issued in MO
Legal business name
RAYMOND A. BRICKHOUSE, DPM LLC
Practice address
3535 S Jefferson Ave Ste 2
Saint Louis, MO 63118-3930
Phone
(314) 381-1802
Fax
(866) 927-4145
NPI assigned
Jul 29, 2016
Organization subpart
Yes
Parent organization
RAYMOND A. BRICKHOUSE, DPM LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 29, 2016

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

Authorized official

Name
Dr. Raymond A Brickhouse Jr., DPM
Title
Owner
Phone
(314) 381-1800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 2008026233 MO Primary

Addresses

Primary practice location

3535 S Jefferson Ave Ste 2
Saint Louis, MO 63118-3930

Mailing address

6400 Clayton Rd Ste 412
Saint Louis, MO 63117-1850
Phone (314) 381-1800

Other identifiers 1

IdentifierTypeStateIssuer
1437314812MedicaidMO

National Provider Directory

National Provider Directory
Part of
Raymond a Brickhouse DPM LL

NPI Registry JSON

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

{
    "created_epoch": "1469750400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1469750400000",
    "number": "1780137356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6400 CLAYTON RD STE 412",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631171850",
            "telephone_number": "314-381-1800",
            "fax_number": "866-927-4145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3535 S JEFFERSON AVE STE 2",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631183930",
            "telephone_number": "314-381-1802",
            "fax_number": "866-927-4145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAYMOND A. BRICKHOUSE, DPM LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RAYMOND A. BRICKHOUSE, DPM LLC",
        "enumeration_date": "2016-07-29",
        "last_updated": "2016-07-29",
        "status": "A",
        "authorized_official_last_name": "BRICKHOUSE",
        "authorized_official_first_name": "RAYMOND",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "314-381-1800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MO",
            "license": "2008026233",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1437314812",
            "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 Jul 29, 2016; 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.