NPIMap

Organization Active NPI

Midwest Medical Associates Inc

  • Primary Care Clinic/Center
  • Saint Louis, MO
National Provider Identifier
1992721047
Registry record updated Nov 13, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
MO100186 Issued in MO
Legal business name
MIDWEST MEDICAL ASSOCIATES INC
Practice address
4346 Loughborough Ave
Saint Louis, MO 63116-2104
Phone
(314) 481-7030
Fax
(314) 481-7120
NPI assigned
Jul 14, 2006
Last updated
Nov 13, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2007

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

Authorized official

Name
Mr. Alexander Rudoi, MDNPI 1740254374
Title
Physician
Phone
(314) 481-7030

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
Primary Care Clinic/Center 261QP2300X MO100186 MO Primary

Addresses

Primary practice location

4346 Loughborough Ave
Saint Louis, MO 63116-2104

Mailing address

4346 Loughborough Ave
Saint Louis, MO 63116-2104
Phone (314) 481-7030

Other names 1

  • Grandel Medical Former legal business name

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

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": "1152835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194912000000",
    "number": "1992721047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4346 LOUGHBOROUGH AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631162104",
            "telephone_number": "314-481-7030",
            "fax_number": "314-481-7120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4346 LOUGHBOROUGH AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631162104",
            "telephone_number": "314-481-7030",
            "fax_number": "314-481-7120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWEST MEDICAL ASSOCIATES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-14",
        "last_updated": "2007-11-13",
        "status": "A",
        "authorized_official_last_name": "RUDOI",
        "authorized_official_first_name": "ALEXANDER",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "314-481-7030",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "MO",
            "license": "MO100186",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Grandel Medical",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2007; 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.