PHYSICIAN GROUPS LC


Address: 1040 N Mason Rd, Suite 206, Saint Louis, MO 63141-6399
Phone: 3148781950

PHYSICIAN GROUPS LC (NPI# 1124194212) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1124194212
Entity Type Organization
Organization Name PHYSICIAN GROUPS LC
Other Organization Name GI CONSULTANTS
Practice Address 1040 N Mason Rd
Suite 206
Saint Louis
MO 63141-6399
Mailing Address 670 Mason Ridge Center Dr
Suite 300
Saint Louis
MO 63141-8573
Practice Telephone 3148781950
Practice Fax Number 3148783022
Mailing Telephone 3149967644
Mailing Fax Number 3149967658
Enumeration Date 2006-11-28
Last Update Date 2008-03-26
Authorized Official Name RAYMOND P DAVIDSON II (PRESIDENT)
Authorized Official Telephone 3142862028
Authorized Official Credential MD
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QM2500X Clinic/Center
Specialization: Medical Specialty
Ambulatory Health Care Facilities

Other Provider/Organization Names

Other Name Type Code
GI Consultants Doing Business As Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1033236948 Physician Groups Lc Allergy & Immunology 301 West Washington Street, Suite 5, Farmington, MO 63640-1921 2007-03-23
1144357278 Physician Groups Lc Family Medicine 1110 Wolfrum Rd, Weldon Spring, MO 63304-7796 2007-02-27
1427114990 Physician Groups Lc Clinic/Center 1103 W Liberty, Farmington, MO 63640-1921 2006-12-29
1770650020 Physician Groups Lc Clinic/Center 6 Jungermann Road, Suite 108, Saint Peters, MO 63376 2006-11-30
1679640007 Physician Groups Lc Clinic/Center 3528 Patterson Rd, Florissant, MO 63031-1311 2006-11-29
1285664268 Physician Groups Lc Clinic/Center 670 Mason Ridge Center Dr, Suite 300, Saint Louis, MO 63141-8573 2006-07-04
1750562542 Physician Groups Lc Obstetrics & Gynecology 1 Barnes Jewish Hospital Plz, Ste. 16312, Saint Louis, MO 63110-1003 2007-11-20
1790978757 Physician Groups Lc Internal Medicine 2 Progress Point Ct, Suite 101c, O Fallon, MO 63368-2208 2007-08-23
1043403009 Physician Groups Lc Obstetrics & Gynecology 70 Jungermann Cir, Suite 101, Saint Peters, MO 63376-1622 2007-08-23
1598958787 Physician Groups Lc Colon & Rectal Surgery 11155 Dunn Rd, Ste. 312e Bldg. 1, Saint Louis, MO 63136-6150 2007-08-22

Office Location

Street Address 1040 N MASON RD
SUITE 206
City SAINT LOUIS
State MO
Zip Code 63141-6399

Providers in the same location

NPI Name Taxonomy Address Enumeration
1326020041 Michele M. Thomas Emergency Medicine 1040 N Mason Rd, Ste 102, Saint Louis, MO 63141-6399 2005-11-17
1598238917 Katharine Louise Cella Nurse Practitioner 1040 N Mason Rd, Ste 103, Saint Louis, MO 63141-6399 2019-01-08
1629552138 Viktoria Meier Nurse Practitioner 1040 N Mason Rd, Ste 206, Saint Louis, MO 63141-6399 2018-09-20
1881108413 Sarah Rebecca Hartmann Nurse Practitioner 1040 N Mason Rd, Ste 103, Saint Louis, MO 63141-6399 2017-11-17
1396186573 Rachael Jeanette Mangiore Audiologist 1040 N Mason Rd, Ste 123, Saint Louis, MO 63141-6399 2013-07-16
1497019897 Maureen Danielle Lyons Internal Medicine 1040 N Mason Rd, Ste 103, Saint Louis, MO 63141-6399 2012-06-29
1790050268 Amy Lynn Lee Nurse Practitioner 1040 N Mason Rd, Saint Louis, MO 63141-6399 2012-03-17
1053690537 Heidi Hope Tastet Family Medicine 1040 N Mason Rd, Ste 103, Saint Louis, MO 63141-6399 2011-08-15
1831498997 Karry Louise Brim Physician Assistant 1040 N Mason Rd, Saint Louis, MO 63141-6399 2011-03-15
1568792539 Melissa Korenblat-hanin Social Worker 1040 N Mason Rd, Suite 115, Saint Louis, MO 63141-6399 2010-01-13
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1679102842 Noor Ramadan Pharmacist 628 North New Ballad Road, Suite A, Creve Coeur, MO 63141 2020-04-08
1497381206 Washington University Durable Medical Equipment & Medical Supplies 1044 North Mason Road, Suite 110/210, St. Louis, MO 63141 2020-03-13
1154956498 Ashleigh Clendenny Physician Assistant Mercy Hospital St. Louis, 615 S New Ballas Rd, St. Louis, MO 63141 2020-03-06
1801429410 Emili Lou Haley Registered Nurse 650 Maryville Drive, St Louis, MO 63141 2020-02-21
1629553110 Rebecca Kathleen Pike Social Worker West County Psychological Associates, 12125 Woodcrest Executive Drive #110, St. Louis, MO 63141 2018-10-01
1649756099 River City Sedation Associates, LLC Nurse Anesthetist, Certified Registered 12855 N 40 Dr Ste 150, Saint Louis, MO 63141 2018-07-18
1205333952 Ear Care and Hearing of St. Louis Hearing Aid Equipment 11630 Studt Ave Ste 210, Creve Coeur, MO 63141 2018-04-10
1659897486 Erin Goodman Physical Therapist 10560 Old Olive St. Rd, Suite 100, Creve Coeur, MO 63141 2017-08-14
1093230450 Center for Urologic Surgery LLC Clinic/Center 12855 N 40 Dr Ste 100, Saint Louis, MO 63141 2017-08-07
1871016105 Jacob Farley Tanner Specialist/Technologist 1054 Town and Four Parkway Dr, Creve Coeur, MO 63141 2017-07-19
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Taxonomy Information

Taxonomy Code 261QM2500X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Medical Specialty

Taxonomy Definition

An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).
Notes: [7/1/2003: new]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1871044735 Susan D Purcell Md Dermatology LLC Clinic/Center 969 N Mason Rd Ste 170, Saint Louis, MO 63141-6387 2016-10-16
1154730414 Mohammed Z Siddiqui Medical Consulting LLC Clinic/Center 10 Overbrook Dr, Saint Louis, MO 63124-1482 2014-08-11
1376875393 Ballas Chiropractic Centre Inc Clinic/Center 11639 Studt Ave, Saint Louis, MO 63141-7015 2010-02-01
1285664268 Physician Groups Lc Clinic/Center 670 Mason Ridge Center Dr, Suite 300, Saint Louis, MO 63141-8573 2006-07-04
1437185782 Missouri Cvs Pharmacy, L.L.C. Clinic/Center 6600 Clayton Rd, Saint Louis, MO 63117-1602 2006-06-25
1104861129 Missouri Cvs Pharmacy, L.L.C. Clinic/Center 10650 Olive Blvd, Saint Louis, MO 63141-7834 2006-06-17
1730540196 Vein Specialties and Medi-spa, LLC Clinic/Center 1035 Bellevue Ave Ste 212, Saint Louis, MO 63117-1846 2016-03-14
1114344348 St Louis Kidney, LLC Clinic/Center 12855 N 40 Dr, Suite 205, Saint Louis, MO 63141-8657 2014-03-26
1003246026 True Results Missouri, LLC Clinic/Center 12855 N 40 Dr, Suite 275, Saint Louis, MO 63141-8657 2013-11-13
1811268428 Joseph M Seria Md LLC Clinic/Center 3915 Watson Rd, Suite 204, Saint Louis, MO 63109-1251 2012-01-13
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Competitor

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City SAINT LOUIS
Zip Code 63141

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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