Judith A Dibble Kiske, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

R8G55 Issued in MO

Practice address

3023 N Ballas Rd Ste 500
Saint Louis, MO 63131-2359

Phone

(314) 996-7930

Fax

(314) 996-7935

NPI assigned

Jul 14, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Judith Ann Nations Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Physician Groups LC

  • Multi-Specialty Clinic/Center
  • Saint Louis, MO
  • NPI 1285664268

  Internal Medicine

  NPD (past)

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614729600000",
    "number": "1972529972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3023 N BALLAS RD STE 500",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631312359",
            "telephone_number": "314-996-7930",
            "fax_number": "314-996-7935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3023 N BALLAS RD STE 500",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631312359",
            "telephone_number": "314-996-7930",
            "fax_number": "314-996-7935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIBBLE KISKE",
        "first_name": "JUDITH",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-14",
        "last_updated": "2021-03-03",
        "certification_date": "2021-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "R8G55",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110218977",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "BJC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3023 N Ballas Rd Ste 500",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631312359",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JUDITH",
            "last_name": "NATIONS",
            "middle_name": "ANN",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Alyson Diaz-Kleine, M.S., CCC-SLP
• Jason A Diaz, MD
• Jennifer Elizabeth Long Diaz, MD PHD
• Julie Diaz, LMHP
• Alison Dibarto, D.C.
• Dikson Dibe Gondim, M.D.
• Lori Renee Dibler
• Paul Allen Dicamillo, MD
• Shannon Marie Dicianno, DPT
• Stacy Dick, OT

• Internal Medicine Physician in Saint Louis, MO
• Providers in Saint Louis, 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 Mar 3, 2021; 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.