Individual provider Active NPI

Wit Anthony Jamry, MD

  • Geriatric Medicine (Internal Medicine) Physician
  • Saint Louis, MO
National Provider Identifier
1902881279
Registry record updated Aug 16, 2011
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.

Matched on NPI only. Confirm current status with the OIG exclusions search before relying on it.

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
MO 37003 Issued in MO
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

Updated by the provider on Aug 16, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
203167226MedicaidMO
110160439OtherRAILROAD 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. Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MO 37003MOMDGeriatric Medicine (Internal Medicine) Physician

Interoperability endpoints

  • FHIR API: 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

Verify at the official NPI Registry.