Long Term Care of North County LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

LONG TERM CARE OF NORTH COUNTY LLC

Practice address

4401 Parker Rd
Black Jack, MO 63033-4266

Phone

(314) 312-0720

NPI assigned

Nov 10, 2017

Last updated

Dec 22, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mary Colette Schmidt, MDNPI 1174504682

Title

Owner

Phone

(314) 922-4048

Specialties & licenses 1

Addresses

Practitioners 1

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.

• Mary Colette Schmidt, M.D.

  • Internal Medicine Physician
  • Black Jack, MO
  • NPI 1174504682
  Authorized official Same address or phone

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

{
    "created_epoch": "1510272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1703203200000",
    "number": "1962915074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 611",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630320611",
            "telephone_number": "314-312-0720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4401 PARKER RD",
            "city": "BLACK JACK",
            "state": "MO",
            "postal_code": "630334266",
            "telephone_number": "314-312-0720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONG TERM CARE OF NORTH COUNTY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-10",
        "last_updated": "2023-12-22",
        "certification_date": "2023-12-22",
        "status": "A",
        "authorized_official_last_name": "SCHMIDT",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "COLETTE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "314-922-4048",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Black Jack, MO
• Providers in Black Jack, 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 Dec 22, 2023; 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.