Michael Calvin Neill Jr.

Primary specialty

Nurse's AideTaxonomy code 376K00000X

License

155183 Issued in MO

Practice address

100 Medical PLZ
Lake St Louis, MO 63367-1366

Phone

(636) 625-5200

NPI assigned

Nov 20, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1605830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605830400000",
    "number": "1871196758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19728 TOWNSHIP LINE RD",
            "city": "WARRENTON",
            "state": "MO",
            "postal_code": "633834448",
            "telephone_number": "636-279-4658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MEDICAL PLZ",
            "city": "LAKE ST LOUIS",
            "state": "MO",
            "postal_code": "633671366",
            "telephone_number": "636-625-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEILL",
        "first_name": "MICHAEL",
        "middle_name": "CALVIN",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-11-20",
        "last_updated": "2020-11-20",
        "certification_date": "2020-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse's Aide",
            "state": "MO",
            "license": "155183",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Nurse's Aide in Lake St Louis, MO
• Providers in Lake St Louis, MO by specialty
• Nurse's Aide in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2020; 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.