Robert V Griesbaum, M.D.

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

License

R7958 Issued in MO

Practice address

12700 Southfork Rd
Saint Louis, MO 63128-3201

Phone

(314) 892-6565

Fax

(314) 892-4828

NPI assigned

Oct 13, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Intermed Medical Consultants Inc

  • Pulmonary Disease Physician
  • Saint Louis, MO
  • NPI 1003804139
  NPD (past) Authorized official

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

{
    "created_epoch": "1129161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489449600000",
    "number": "1902894934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12700 SOUTHFORK RD",
            "address_2": "STE 270",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631283201",
            "telephone_number": "314-892-6565",
            "fax_number": "314-892-4828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12700 SOUTHFORK RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631283201",
            "telephone_number": "314-892-6565",
            "fax_number": "314-892-4828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIESBAUM",
        "first_name": "ROBERT",
        "middle_name": "V",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-13",
        "last_updated": "2017-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "MO",
            "license": "R7958",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "MO",
            "license": "R7958",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201142817",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ida Jane Grider, LPC
• Carly Gridley, MD
• Patrick Grierson, MD
• Andrew Robert Griesbaum, ACNP
• Mary Magdalene Griesbaum, ACNP
• Diane Griesenauer
• Erin Marie Griesenauer, AGACNP-BC
• Stephanie Renee Griesenauer, PNP
• Victoria Noelle Griesenauer, LCSW
• Rainey Elizabeth Griffard

• Pulmonary Disease Physician in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Pulmonary Disease Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2017; 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.