NPIMap

Organization Active NPI

Physician Groups LC

Doing business as Office of Dr. Brick

  • Primary Care Clinic/Center
  • Saint Charles, MO
National Provider Identifier
1831265966
Registry record updated Jan 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
PHYSICIAN GROUPS LC
Doing business as
Office of Dr. Brick
Practice address
2536 S Old Highway 94
Suite 230
Saint Charles, MO 63303-5612
Phone
(636) 928-1144
Fax
(636) 928-2476
NPI assigned
Nov 28, 2006
Last updated
Jan 4, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2008

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

Authorized official

Name
Raymond P Davidson II, MD
Title
President
Phone
(314) 286-2028

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X NU Primary

Addresses

Primary practice location

2536 S Old Highway 94
Suite 230
Saint Charles, MO 63303-5612

Mailing address

670 Mason Ridge Center Dr
Suite 300
Saint Louis, MO 63141-8573
Phone (314) 996-7644

Other names 1

  • Office of Dr. Brick Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Mardonio Yap MD6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2536 S Old Highway 94
Ste 230
Saint Charles, MO 63303
Phone (636) 928-1144

NPI Registry JSON

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199404800000",
    "number": "1831265966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "670 MASON RIDGE CENTER DR",
            "address_2": "SUITE 300",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418573",
            "telephone_number": "314-996-7644",
            "fax_number": "314-996-7658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2536 S OLD HIGHWAY 94",
            "address_2": "SUITE 230",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633035612",
            "telephone_number": "636-928-1144",
            "fax_number": "636-928-2476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIAN GROUPS LC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-28",
        "last_updated": "2008-01-04",
        "status": "A",
        "authorized_official_last_name": "DAVIDSON",
        "authorized_official_first_name": "RAYMOND",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "314-286-2028",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Office of Dr. Brick",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Saint Charles, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2008; 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.