Individual provider Active NPI

Camilla Mae Kachar

  • Student in an Organized Health Care Education/Training Program
  • Saint Louis, MO
National Provider Identifier
1972290823
Registry record updated Jun 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
1201 S Grand Blvd
Saint Louis, MO 63104-1016
Phone
(314) 257-8000
NPI assigned
Apr 20, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 16, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

1201 S Grand Blvd
Saint Louis, MO 63104-1016

Mailing address

522 Woodmoor Ridge CT
Wildwood, MO 63011-1776
Phone (314) 680-4667

Other practice location 1

6420 Clayton Rd
Saint Louis, MO 63117-1811
Phone (314) 768-8000

Other practice location 2

1465 S Grand Blvd
Saint Louis, MO 63104-1003
Phone (314) 557-5600

Other practice location 3

1225 S Grand Blvd
Saint Louis, MO 63104-1016
Phone (314) 977-4440

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250715002065 MO Order and Referring Only - AnesthesiologyPractitioner - Anesthesiology 2961917380

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1681948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686873600000",
    "number": "1972290823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "522 WOODMOOR RIDGE CT",
            "city": "WILDWOOD",
            "state": "MO",
            "postal_code": "630111776",
            "telephone_number": "314-680-4667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 S GRAND BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631041016",
            "telephone_number": "314-257-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6420 Clayton Rd",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631171811",
            "country_code": "US",
            "telephone_number": "314-768-8000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1465 S Grand Blvd",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631041003",
            "country_code": "US",
            "telephone_number": "314-557-5600",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1225 S Grand Blvd",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631041016",
            "country_code": "US",
            "telephone_number": "314-977-4440",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KACHAR",
        "first_name": "CAMILLA",
        "middle_name": "MAE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-04-20",
        "last_updated": "2023-06-16",
        "certification_date": "2023-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.