Missouri Occupational Medicine

Primary specialty

Corporate Health Clinic/CenterTaxonomy code 261QC1800X

Legal business name

MISSOURI OCCUPATIONAL MEDICINE

Practice address

1 W 12TH St
Washington, MO 63090-4416

Phone

(636) 239-0735

NPI assigned

Feb 21, 2024

Last updated

Feb 21, 2024By 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

Bobby Enkvetchakul, MD, MPHNPI 1487764882

Title

Physician

Phone

(636) 239-0735

Specialties & licenses 1

Addresses

Locations

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.

• Bobby Vitaya Enkvetchakul, MD

  • Occupational Medicine Clinic/Center
  • Washington, MO
  • NPI 1487764882
  NPD Authorized official

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

{
    "created_epoch": "1708473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708473600000",
    "number": "1972369619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1275",
            "city": "WASHINGTON",
            "state": "MO",
            "postal_code": "630908275",
            "telephone_number": "636-390-9277",
            "fax_number": "636-239-0907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 W 12TH ST",
            "city": "WASHINGTON",
            "state": "MO",
            "postal_code": "630904416",
            "telephone_number": "636-239-0735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSOURI OCCUPATIONAL MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-21",
        "last_updated": "2024-02-21",
        "certification_date": "2024-02-21",
        "status": "A",
        "authorized_official_last_name": "ENKVETCHAKUL",
        "authorized_official_first_name": "BOBBY",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "636-239-0735",
        "authorized_official_credential": "MD, MPH"
    },
    "taxonomies": [
        {
            "code": "261QC1800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Corporate Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Megan Kathleen Minner, DC
• Muhammad Azim Mirza, M.D.
• Missouri CVS Pharmacy LLC (CVS Pharmacy #17330)
• Missouri CVS Pharmacy, L.L.C. (CVS Pharmacy #18082)
• Missouri Foot and Ankle Institute
• Missouri Podiatric Surgicare LLC
• Missouri Podiatric Surgicare LLC
• Missouri Valley Anesthesia, PC
• Kersten Ann Mitchell
• Mobility Scooters of Washington LLC

• Corporate Health Clinic/Center in Washington, MO
• Providers in Washington, MO by specialty
• Corporate Health Clinic/Center in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2024; 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.