Timothy James Pratt, M.D.

Internal Medicine in Fenton, MO. Individual provider (NPI-1).

NPI number1104872068

StatusActive

Last updated in NPPESJun 19, 2024

Details

NPI: 1104872068
Entity type: Individual (NPI-1)
Name: Timothy James Pratt
Credential: M.D.
Sex: Male
Sole proprietor: Yes
Enumeration date: May 25, 2006
Certification date: Jun 19, 2024
Last updated: Jun 19, 2024

Medicare and OIG

Medicare enrolled (PECOS): Yes · PRACTITIONER - INTERNAL MEDICINE
Can order and refer: Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice Yes
OIG exclusion list: This NPI is not listed

CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
207R00000X	Internal Medicine	R9E55	MO	Yes

Practice location

1011 Bowles Avenue
Suite 121
Fenton, MO 63026

Phone 314-766-2066 · Fax 636-326-1802

Mailing address

Po Box 220375
Kirkwood, MO 63122-0375

Phone 314-766-2066 · Fax 636-326-1802

Is something wrong?

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Other Internal Medicine Physician providers in Fenton, MO

All 21 Internal Medicine Physician providers in Fenton · All 705 providers in Fenton

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