SSM ST. CHARLES CLINIC MEDICAL GROUP, INC. (NPI# 1285741629) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285741629 |
| Entity Type | Organization |
| Organization Name | SSM ST. CHARLES CLINIC MEDICAL GROUP, INC. |
| Other Organization Name | SSM HEALTH MEDICAL GROUP |
| Practice Address |
172 Professional Parkway Troy MO 63379-1520 |
| Mailing Address |
1551 Wall St Suite 310 Saint Charles MO 63303-3539 |
| Practice Telephone | 6364626106 |
| Practice Fax Number | 6366692401 |
| Mailing Telephone | 6366692268 |
| Mailing Fax Number | 3142098127 |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2016-01-15 |
| Authorized Official Name | MS. LAURA PULLUM (BILLING MANAGER) |
| Authorized Official Telephone | 6366692434 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
R9286 | MO | Allopathic & Osteopathic Physicians |
| Y | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 501887806 | 05 |
| Other Name | Type Code |
|---|---|
| SSM Health Medical Group | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528421260 | Ssm St. Charles Clinic Medical Group, Inc. | Durable Medical Equipment & Medical Supplies | 1475 Kisker Rd, Suite 200, Saint Charles, MO 63304-8781 | 2016-03-31 |
| 1578670949 | Ssm St. Charles Clinic Medical Group, Inc. | Family Medicine | 722 N Highway 47, Suite B, Warrenton, MO 63383-1108 | 2006-08-23 |
| 1811932973 | Ssm St. Charles Clinic Medical Group, Inc. | Internal Medicine | 1551 Wall St, Suite 400, Saint Charles, MO 63303-3539 | 2006-06-20 |
| Street Address |
172 PROFESSIONAL PARKWAY |
| City | TROY |
| State | MO |
| Zip Code | 63379-1520 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487615241 | Rodrigo G Goh | Internal Medicine | 172 Professional Parkway, Po Box A, Troy, MO 63379-1520 | 2006-03-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336746601 | Cathleen Burks | Counselor | 384 Rockport Dr, Troy, MO 63379 | 2020-10-08 |
| 1851818058 | Sarah Tippit | Occupational Therapist | 39 Cattail Pl, Troy, MO 63379 | 2017-08-28 |
| 1104360239 | Lori Seulean LLC | Counselor | 410 Sydna Ct, Troy, MO 63379 | 2016-12-08 |
| 1659827210 | Elisabeth Marie Nation | Physical Therapist | 722 N Hwy 47 Suite A, Warrenton, MO 63379 | 2016-09-01 |
| 1598054587 | Janice Ann Mills | Counselor | 1385 Creech School Road, Troy, MO 63379 | 2011-03-31 |
| 1437450871 | All Family Chiropractic LLC | Chiropractor | 9 Plaza, Troy, MO 63379 | 2010-11-16 |
| 1063713246 | Troy Family Dentistry, LLC | Dentist | 128 Professional Parkway, Troy, MO 63379 | 2010-11-04 |
| 1437478476 | Jennifer G Ray | Pediatrics | 164 Professional Pkwy, Troy, MO 63379 | 2010-05-28 |
| 1184868523 | Troy Residential, LLC | Assisted Living Facility | 159 Professional Parkway, Troy, MO 63379 | 2009-04-29 |
| 1639356793 | Susan Kaye Galloway | Counselor | 104 Mound, Troy, MO 63379 | 2008-01-30 |
| Find all providers in zip 63379 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346801032 | Compassionate Medical Services Plc | Internal Medicine | 2847 Briarwood Dr, Troy, MI 48085-1153 | 2019-06-24 |
| 1891262341 | James Bazzi Md PC | Internal Medicine | 3455 Livernois Rd, Troy, MI 48083-5063 | 2018-11-01 |
| 1649707134 | Aspan Medical Services, Pllc | Internal Medicine | 3400 Livernois Rd, Troy, MI 48083-5063 | 2017-05-16 |
| 1689105421 | Ausi Medical Center PC | Internal Medicine | 5032 Rochester Rd, Suite 200, Troy, MI 48085-3454 | 2017-03-23 |
| 1598202467 | Mercy Family Care Center Pllc | Internal Medicine | 4091 Chatwal Ct, Troy, MI 48085-0001 | 2017-01-30 |
| 1811349822 | Kruthika Shanmugam | Internal Medicine | 2064 Coolidge Hwy, Apt 210, Troy, MI 48084-3616 | 2016-07-01 |
| 1437506052 | Lequishia Alexander Md Pllc | Internal Medicine | 2366 John R Rd Apt 205, Troy, MI 48083-2573 | 2016-05-24 |
| 1528478948 | Ahmed Mostafa Naderramadan Mohamed | Internal Medicine | 2791 Charter Dr Apt 117, Troy, MI 48083-1325 | 2014-05-07 |
| 1033539846 | Nashwa Khogali-jakary | Internal Medicine | 3290 W Big Beaver Rd Ste 420, Troy, MI 48084-2931 | 2014-04-18 |
| 1154740942 | Waseem Ghanim Petros | Internal Medicine | 2221 Livernois Rd Ste 100, Troy, MI 48083-1603 | 2014-04-09 |
| Find all providers in TROY | ||||
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| 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.