Creve Coeur Internal Medicine, LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

CREVE COEUR INTERNAL MEDICINE, LLC

Practice address

11550 Olive Blvd
Ste 140
Creve Coeur, MO 63141-7111

Phone

(314) 576-2490

NPI assigned

Jan 6, 2016

Organization subpart

Yes

Parent organization

ST. LUKES MEDICAL GROUPAs reported in NPPES

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

Authorized official

Name

Rick Sonne

Title

Director

Phone

(314) 576-2490

Specialties & licenses 1

Addresses

Part of

St Lukes Medical Group

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• St. Lukes Medical Group

  • Family Medicine Physician
  • Chesterfield, MO
  • NPI 1215308945
  NPPES parent name

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

{
    "created_epoch": "1452038400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1452038400000",
    "number": "1962868901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 SAINT LUKES CENTER DR",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630173518",
            "telephone_number": "314-576-2490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11550 OLIVE BLVD",
            "address_2": "STE 140",
            "city": "CREVE COEUR",
            "state": "MO",
            "postal_code": "631417111",
            "telephone_number": "314-576-2490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREVE COEUR INTERNAL MEDICINE, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ST. LUKES MEDICAL GROUP",
        "enumeration_date": "2016-01-06",
        "last_updated": "2016-01-06",
        "status": "A",
        "authorized_official_last_name": "SONNE",
        "authorized_official_first_name": "RICK",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "314-576-2490"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Creve Coeur, MO
• Providers in Creve Coeur, MO by specialty
• Internal Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2016; 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.