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NPI 1053945105ActiveOrganization· Preferred Provider Organization· Saint Louis, MO
Preferred Provider Organization in Saint Louis, Missouri, registered in NPPES in February 2020. The authorized official on file is Deonda Poke, Executive Director.
Overview
| NPI | 1053945105 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Feb 27, 2020 |
| Last updated in NPPES | Feb 27, 2020 |
| Certified by provider | Feb 27, 2020 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Preferred Provider Organization Primary | 305R00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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