Active NPI
Wayne Joseph Parks
- Medical Technologist
- Saint Louis, MO
National Provider Identifier
1962028555
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Technologist
- License
- 25321087
- Practice address
- 11133 Dunn Rd
Saint Louis, MO 63136-6163 - Phone
- (315) 653-5000
- NPI assigned
- Jun 19, 2020
- 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 |
|---|---|---|---|---|
| Medical Technologist | 246QM0706X | 25321087 | MO | Primary |
Addresses
Primary practice location
11133 Dunn Rd
Saint Louis, MO 63136-6163
Mailing address
1879 McKelvey Hill Dr Apt E
Maryland Heights, MO 63043-3921
Phone (314) 579-0973
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25321087 | MO | MD | Medical Technologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1592524800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1592524800000",
"number": "1962028555",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1879 MCKELVEY HILL DR APT E",
"city": "MARYLAND HEIGHTS",
"state": "MO",
"postal_code": "630433921",
"telephone_number": "314-579-0973"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11133 DUNN RD",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631366163",
"telephone_number": "315-653-5000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PARKS",
"first_name": "WAYNE",
"middle_name": "JOSEPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-06-19",
"last_updated": "2020-06-19",
"certification_date": "2020-06-19",
"status": "A"
},
"taxonomies": [
{
"code": "246QM0706X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Pathology, Medical Technologist",
"state": "MO",
"license": "25321087",
"primary": true
}
],
"identifiers": [],
"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 Jun 19, 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.