Organization Active NPI

Internal Medicine Associates of West County P C

  • Internal Medicine Physician
  • Saint Louis, MO
National Provider Identifier
1790937654
Registry record updated Oct 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
INTERNAL MEDICINE ASSOCIATES OF WEST COUNTY P C
Practice address
522 N New Ballas Rd
Ste. 371
Saint Louis, MO 63141-6857
Phone
(314) 994-9338
Fax
(314) 432-4802
NPI assigned
Oct 22, 2008
Last updated
Oct 29, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2008

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

Authorized official

Name
Dr. Tinna P King, MDNPI 1932201092
Title
Doctor
Phone
(314) 994-9338

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

522 N New Ballas Rd
Ste. 371
Saint Louis, MO 63141-6857

Mailing address

522 N New Ballas Rd
Ste. 371
Saint Louis, MO 63141-6857
Phone (314) 994-9338

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081028000797 MO Part B Supplier - Clinic/Group Practice 4486712890 Receives reassigned benefits from 1 practitioner
Practice locations: Creve Coeur, MO

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
26D0975979Internal Medicine Associates of West County522 North New Ballas Road, Suite 371, Creve Coeur, MO 63141Certificate of waiverJul 20, 2028

National Provider Directory

National Provider Directory

Locations

522 N New Ballas Rd
Ste 371
Saint Louis, MO 63141
Phone (314) 994-9338

Practitioners & affiliated clinicians

Practitioners 1

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": "1224633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225238400000",
    "number": "1790937654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "522 N NEW BALLAS RD",
            "address_2": "STE. 371",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631416857",
            "telephone_number": "314-994-9338",
            "fax_number": "314-432-4802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "522 N NEW BALLAS RD",
            "address_2": "STE. 371",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631416857",
            "telephone_number": "314-994-9338",
            "fax_number": "314-432-4802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERNAL MEDICINE ASSOCIATES OF WEST COUNTY P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-22",
        "last_updated": "2008-10-29",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "TINNA",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "314-994-9338",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "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 Oct 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.