NPIMap

Organization Active NPI

La Clinica Latino Community Health Centers

  • Voluntary or Charitable Agency
  • Saint Louis, MO
National Provider Identifier
1871663559
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Voluntary or Charitable AgencyTaxonomy code 251V00000X
License
R1H15 Issued in MO
Legal business name
LA CLINICA LATINO COMMUNITY HEALTH CENTERS
Practice address
3646 Fairview Ave
Saint Louis, MO 63116-4747
Phone
(314) 664-5565
Fax
(314) 773-0709
NPI assigned
Nov 9, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. David C. Campbell, M.D., M.ED.
Title
Medical Director
Phone
(314) 664-5565

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Voluntary or Charitable Agency 251V00000X R1H15 MO Primary

Addresses

Primary practice location

3646 Fairview Ave
Saint Louis, MO 63116-4747

Mailing address

3646 Fairview Ave
Saint Louis, MO 63116-4747
Phone (314) 664-5565

Other names 1

  • La Clinica Doing business as

National Provider Directory

National Provider Directory
Tax ID family
La Clinica3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

NPI Registry JSON

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1871663559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3646 FAIRVIEW AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631164747",
            "telephone_number": "314-664-5565",
            "fax_number": "314-773-0709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3646 FAIRVIEW AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631164747",
            "telephone_number": "314-664-5565",
            "fax_number": "314-773-0709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LA CLINICA LATINO COMMUNITY HEALTH CENTERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CAMPBELL",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "314-664-5565",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D., M.ED."
    },
    "taxonomies": [
        {
            "code": "251V00000X",
            "taxonomy_group": "",
            "desc": "Voluntary or Charitable",
            "state": "MO",
            "license": "R1H15",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "La Clinica",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Aug 22, 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.