Active NPI
Wit Anthony Jamry, MD
- Geriatric Medicine (Internal Medicine) Physician
- Saint Louis, MO
National Provider Identifier
1902881279
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128a(1) exclusion effective Jan 20, 2014.
Key facts
NPPES NPI Registry- Primary specialty
- Geriatric Medicine (Internal Medicine) Physician
- License
- MO 37003
- Practice address
- 5621 Delmar Blvd
#105
Saint Louis, MO 63112-2656 - Phone
- (314) 367-2727
- Fax
- (314) 367-2989
- NPI assigned
- Dec 9, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Geriatric Medicine (Internal Medicine) Physician | 207RG0300X | MO 37003 | MO | Primary |
Addresses
Primary practice location
5621 Delmar Blvd
#105
Saint Louis, MO 63112-2656
Mailing address
7137 Maryland Ave
Saint Louis, MO 63130-4417
Phone (314) 721-0675
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 203167226 | Medicaid | MO | |
| 110160439 | Other | RAILROAD MEDICARE |
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)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MO 37003 | MO | MD | Geriatric Medicine (Internal Medicine) Physician |
Interoperability endpoints
- https://api.platform.athenahealth.com/8596/brand/1/csg/1/fhir/r4
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1134086400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1313452800000",
"number": "1902881279",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7137 MARYLAND AVE",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631304417",
"telephone_number": "314-721-0675",
"fax_number": "314-721-2830"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5621 DELMAR BLVD",
"address_2": "#105",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631122656",
"telephone_number": "314-367-2727",
"fax_number": "314-367-2989"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JAMRY",
"first_name": "WIT",
"middle_name": "ANTHONY",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-09",
"last_updated": "2011-08-16",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Geriatric Medicine",
"state": "MO",
"license": "MO 37003",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "203167226",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "110160439",
"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 Aug 16, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.