Caribe Gastroenterology LLC

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

Legal business name

CARIBE GASTROENTEROLOGY LLC

Practice address

6 Jungermann Cir
Suite 207
Saint Peters, MO 63376-1621

Phone

(636) 498-1700

Fax

(636) 498-1702

NPI assigned

Sep 29, 2006

Organization subpart

No

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

Authorized official

Name

Kim Debold

Title

Account Manager

Phone

(314) 432-2580

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1347494400000",
    "number": "1801988639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1449",
            "city": "MARYLAND HEIGHTS",
            "state": "MO",
            "postal_code": "630430449",
            "telephone_number": "314-432-2580",
            "fax_number": "314-569-3162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 JUNGERMANN CIR",
            "address_2": "SUITE 207",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633761621",
            "telephone_number": "636-498-1700",
            "fax_number": "636-498-1702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARIBE GASTROENTEROLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-29",
        "last_updated": "2012-09-13",
        "status": "A",
        "authorized_official_last_name": "DEBOLD",
        "authorized_official_first_name": "KIM",
        "authorized_official_title_or_position": "ACCOUNT MANAGER",
        "authorized_official_telephone_number": "314-432-2580"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "507577807",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Cheandra Carr
• Jill Marie Carroll

• Gastroenterology Physician in Saint Peters, MO
• Providers in Saint Peters, MO by specialty
• Gastroenterology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2012; 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.