Individual provider Active NPI

Giovanni D'Avossa, MD

  • Neurology Physician
  • Saint Louis, MO
National Provider Identifier
1871519181
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
2000172554 Issued in MO
Practice address
4921 Parkview PL
Ste 6C
Saint Louis, MO 63110-1032
Phone
(314) 362-1408
Fax
(314) 747-2444
NPI assigned
Jul 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 2000172554 MO Primary

Addresses

Primary practice location

4921 Parkview PL
Ste 6C
Saint Louis, MO 63110-1032

Mailing address

PO Box 8221
7425 Forsyth
Saint Louis, MO 63156-8221
Phone (314) 935-0770

Other identifiers 1

IdentifierTypeStateIssuer
199379OtherMO-BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1871519181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8221",
            "address_2": "7425 FORSYTH",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631568221",
            "telephone_number": "314-935-0770",
            "fax_number": "314-935-0575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4921 PARKVIEW PL",
            "address_2": "STE 6C",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101032",
            "telephone_number": "314-362-1408",
            "fax_number": "314-747-2444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "D'AVOSSA",
        "first_name": "GIOVANNI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MO",
            "license": "2000172554",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MO-BLUE SHIELD",
            "identifier": "199379",
            "state": null
        }
    ],
    "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 Jul 8, 2007; 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.