NPIMap

Organization Active NPI

Seniorwell Pod of Missouri LLC

  • Podiatrist
  • Saint Louis, MO
National Provider Identifier
1831689843
Registry record updated Nov 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
SENIORWELL POD OF MISSOURI LLC
Practice address
4625 Lindell Blvd FL 2
Saint Louis, MO 63108-3725
Phone
(844) 882-3127
NPI assigned
May 15, 2018
Last updated
Nov 28, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2018

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

Authorized official

Name
John Moroney
Title
Authorized Official/Ceo
Phone
(844) 882-3127

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X Primary

Addresses

Primary practice location

4625 Lindell Blvd FL 2
Saint Louis, MO 63108-3725

Mailing address

2100 E Lake Cook Rd Ste 1000
Buffalo Grove, IL 60089-1999

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1526342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1543363200000",
    "number": "1831689843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 E LAKE COOK RD STE 1000",
            "city": "BUFFALO GROVE",
            "state": "IL",
            "postal_code": "600891999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4625 LINDELL BLVD FL 2",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631083725",
            "telephone_number": "844-882-3127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SENIORWELL POD OF MISSOURI LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-15",
        "last_updated": "2018-11-28",
        "status": "A",
        "authorized_official_last_name": "MORONEY",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL/CEO",
        "authorized_official_telephone_number": "844-882-3127"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": null,
            "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 Nov 28, 2018; 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.