SSMDEPAUL MEDICAL GROUP (NPI# 1457660896) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457660896 |
| Entity Type | Organization |
| Organization Name | SSMDEPAUL MEDICAL GROUP |
| Practice Address |
1551 Wall St Suite 400 Saint Charles MO 63303-3539 |
| Mailing Address |
1551 Wall St Suite 310 Saint Charles MO 63303-3539 |
| Practice Telephone | 6366692350 |
| Practice Fax Number | 6366692221 |
| Mailing Telephone | 6366692268 |
| Mailing Fax Number | 3142098127 |
| Enumeration Date | 2010-10-04 |
| Last Update Date | 2010-10-04 |
| Authorized Official Name | BRIDGET FRANCIS (CREDENTILAING COORDINATOR) |
| Authorized Official Telephone | 6366692268 |
| Is Organization Subpart | Y |
| Parent Organization Name | SSM DEPAUL MEDICAL GROUP |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | MO | Allopathic & Osteopathic Physicians | |
| Y | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
MO | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 502915705 | 05 |
| Street Address |
1551 WALL ST SUITE 400 |
| City | SAINT CHARLES |
| State | MO |
| Zip Code | 63303-3539 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184685547 | Nadira Adil | Pediatrics | 1551 Wall St, 4th Floor, Saint Charles, MO 63303-3539 | 2006-03-28 |
| 1235599341 | Chalenna C. Cassell | Psychologist | 1551 Wall St, Saint Charles, MO 63303-3539 | 2016-03-02 |
| 1245699578 | Kimberly A Franer | Nurse Practitioner | 1551 Wall St, Suite 400, Saint Charles, MO 63303-3539 | 2016-02-15 |
| 1083072946 | Shannon Haselhorst | Physical Therapist | 1551 Wall St, Suite 110, Saint Charles, MO 63303-3539 | 2016-02-08 |
| 1891123477 | Ssm Depaul Medical Group | Family Medicine | 1551 Wall St, Suite 400, Saint Charles, MO 63303-3539 | 2013-10-17 |
| 1144653049 | Tyler Nicholas Forbes | Physical Therapist | 1551 Wall St, Suite 110, Saint Charles, MO 63303-3539 | 2013-08-14 |
| 1316370224 | Patrick Daniel Fagan | Physical Therapist | 1551 Wall St, Suite 110, Saint Charles, MO 63303-3539 | 2013-08-14 |
| 1770827321 | Paula J Musgrove | Physical Therapist | 1551 Wall St, Saint Charles, MO 63303-3539 | 2012-11-20 |
| 1871808147 | Todd Abramczyk | Physical Therapist | 1551 Wall St, Saint Charles, MO 63303-3539 | 2010-08-11 |
| 1053639211 | Andrea Lynn Montgomery | Physical Therapist | 1551 Wall St, Saint Charles, MO 63303-3539 | 2010-05-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083214787 | Michael Frederick | Pharmacist | 2855 Veterans Memorial Parkway, (pharmacy), Saint Charles, MO 63303 | 2020-10-30 |
| 1710525639 | Cheryl Ann O'dell | Pharmacist | Schnucks Pharmacy, 60 Harvester Square, St Charles, MO 63303 | 2019-12-11 |
| 1255821302 | Melinda R Winfield | Nurse Practitioner | 1313 Park Ct, Saint Charles, MO 63303 | 2018-05-15 |
| 1467904839 | Heather Lilledahl | Speech-Language Pathologist | 2800 Old Muegge Road, Saint Charles, MO 63303 | 2016-11-01 |
| 1437608312 | Preferred Family Healthcare | Counselor | 1559 Old S. River Road, St.charles, MO 63303 | 2016-10-03 |
| 1487109146 | Annette Patricia Davenport | Nurse Practitioner | 1551 Wall Street, Logistics Health Inc, Suite 100, Saint Charles, MO 63303 | 2016-08-23 |
| 1053762328 | Sarah Biondo | Speech-Language Pathologist | 7204 Fountainview Circle, Ofallon, MO 63303 | 2016-06-28 |
| 1710331335 | Lindsey Ann Eilers | Counselor | 1570 South Main, Saint Charles, MO 63303 | 2016-04-20 |
| 1174914600 | Jacquelyn Michele Miller | Pharmacy Technician | 3881 Mexico Road, Saint Charles, MO 63303 | 2015-02-05 |
| 1164838132 | Francelle Denise Neal | Counselor | 2480 Executive Dr Ste 111, Saint Charles, MO 63303 | 2014-07-10 |
| Find all providers in zip 63303 | ||||
| Taxonomy Code | 213ES0103X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Foot & Ankle Surgery |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801083985 | Amod P Paranjpe, Dpm | Podiatrist | 1475 Kisker Rd Ste 260, Saint Charles, MO 63304-8788 | 2007-10-02 |
| 1174653554 | Harry N Bernard | Podiatrist | 34 Green Number 4 Dr, Saint Charles, MO 63303-3336 | 2007-03-06 |
| 1730228958 | Foot & Ankle Center, LLC | Podiatrist | 1519 S Old Highway 94, Saint Charles, MO 63303-3736 | 2007-02-05 |
| 1861906703 | Harness Podiatry Health & Wellness | Podiatrist | 330 1st Capitol Dr Ste 340, Saint Charles, MO 63301-2852 | 2017-11-30 |
| 1700311503 | Jonathan Mathew George | Podiatrist | 1475 Kisker Rd Ste 260, Saint Charles, MO 63304-8788 | 2017-04-29 |
| 1316100290 | Heel To Toe Podiatry LLC | Podiatrist | 1475 Kisker Rd, Suite 260, Saint Charles, MO 63304-8781 | 2008-07-09 |
| 1396925871 | Harry N Bernard Dpm Ltd | Podiatrist | 34 Green Number 4 Dr, Saint Charles, MO 63303-3336 | 2007-11-13 |
| 1700917960 | Feet First Podiatry LLC | Podiatrist | 2318 Highway 94 South Outer Rd, Saint Charles, MO 63303-8301 | 2007-03-08 |
| 1801942024 | Foxfield Foot and Ankle Specialists, PC | Podiatrist | 3381 W Main St, Suite 2, Saint Charles, IL 60175-1008 | 2007-01-29 |
| 1285770909 | Anthony Vincent Pollastrini | Podiatrist | 3381 W Main St, Suite 2, Saint Charles, IL 60175-1008 | 2007-01-29 |
| Find all providers in SAINT CHARLES | ||||
| City | SAINT CHARLES |
| Zip Code | 63303 |
Please comment or provide details below to improve the information on SSMDEPAUL MEDICAL GROUP.
| 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.