NPIMap

Organization Active NPI

Lakeview Medical Group Inc

  • Internal Medicine Physician
  • O'Fallon, MO
National Provider Identifier
1972721025
Registry record updated Nov 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
108025 Issued in MO
Legal business name
LAKEVIEW MEDICAL GROUP INC
Practice address
830 Waterbury Falls Dr
Ste 202
O Fallon, MO 63368-2215
Phone
(636) 278-1670
NPI assigned
Apr 23, 2007
Last updated
Nov 5, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2021

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

Authorized official

Name
Thomas F WrightNPI 1417935974
Title
President
Phone
(636) 397-4012

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 108025 MO Primary

Addresses

Primary practice location

830 Waterbury Falls Dr
Ste 202
O Fallon, MO 63368-2215

Mailing address

1630 Market Center Blvd Ste 201
O Fallon, MO 63368-8407
Phone (636) 397-4012

Other identifiers 1

IdentifierTypeStateIssuer
000013627OtherMOMEDICARE GROUP PTAN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address drwright@wrightvein.org Direct

National Provider Directory

National Provider Directory

Locations

7030 Mexico Rd
Ste A
Saint Peters, MO 63376
Phone (636) 397-4002

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1636070400000",
    "number": "1972721025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1630 MARKET CENTER BLVD STE 201",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633688407",
            "telephone_number": "636-397-4012",
            "fax_number": "636-278-1670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 WATERBURY FALLS DR",
            "address_2": "STE 202",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633682215",
            "telephone_number": "636-278-1670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKEVIEW MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-23",
        "last_updated": "2021-11-05",
        "certification_date": "2021-11-05",
        "status": "A",
        "authorized_official_last_name": "WRIGHT",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "636-397-4012"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "108025",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PTAN",
            "identifier": "000013627",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "drwright@wrightvein.org",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1630 Market Center Blvd Ste 201",
            "city": "O Fallon",
            "state": "MO",
            "country_code": "US",
            "postal_code": "633688407",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in O'Fallon, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 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.