Organization Active NPI

Midwest ENT Centre, PC

  • Otolaryngology Physician
  • Saint Peters, MO
National Provider Identifier
1932236650
Registry record updated Jul 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
Legal business name
MIDWEST ENT CENTRE, PC
Practice address
4790 Executive Centre Pkwy
Saint Peters, MO 63376-1606
Phone
(636) 441-3100
Fax
(636) 441-6784
NPI assigned
Feb 28, 2007
Last updated
Jul 28, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2008

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

Authorized official

Name
John Michael Conoyer, M.D.NPI 1295750586
Title
President
Phone
(636) 441-3100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X NU Primary

Addresses

Primary practice location

4790 Executive Centre Pkwy
Saint Peters, MO 63376-1606

Mailing address

4790 Executive Centre Pkwy
Saint Peters, MO 63376-1606
Phone (636) 441-3100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080805000238 MO Part B Supplier - Clinic/Group Practice 5597839878 Receives reassigned benefits from 13 practitioners
Practice locations: Saint Peters, MO

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
26D2015372Midwest ENT Centre4790 Executive Centre Parkway, Saint Peters, MO 63376Certificate of waiverOct 6, 2026

National Provider Directory

National Provider Directory

Locations

4790 Executive Centre Pkwy
Saint Peters, MO 63376
Phone (636) 441-3100

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217203200000",
    "number": "1932236650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4790 EXECUTIVE CENTRE PKWY",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633761606",
            "telephone_number": "636-441-3100",
            "fax_number": "636-441-6784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4790 EXECUTIVE CENTRE PKWY",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633761606",
            "telephone_number": "636-441-3100",
            "fax_number": "636-441-6784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWEST ENT CENTRE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-28",
        "last_updated": "2008-07-28",
        "status": "A",
        "authorized_official_last_name": "CONOYER",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "636-441-3100",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Peters, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.