SSM MEDICAL GROUP INC. (NPI# 1548578750) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548578750 |
| Entity Type | Organization |
| Organization Name | SSM MEDICAL GROUP INC. |
| Other Organization Name | SSM HEALTH MEDICAL GROUP |
| Practice Address |
1101 Highway K O Fallon MO 63366 |
| Mailing Address |
1551 Wall St Suite 310 Saint Charles MO 63303-3541 |
| Practice Telephone | 6363796363 |
| Practice Fax Number | 6363791297 |
| Mailing Telephone | 6366692268 |
| Mailing Fax Number | 3142098129 |
| Enumeration Date | 2010-09-22 |
| Last Update Date | 2018-07-16 |
| Authorized Official Name | BRIDGET EDER (PROVIDER ENROLLMENT SPECIALIST) |
| Authorized Official Telephone | 6366692268 |
| Is Organization Subpart | Y |
| Parent Organization Name | SSM MEDICAL GROUP INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | MO | Allopathic & Osteopathic Physicians | |
| N | 207R00000X | Internal Medicine | MO | Allopathic & Osteopathic Physicians | |
| N | 207RR0500X |
Internal Medicine Specialization: Rheumatology |
MO | Allopathic & Osteopathic Physicians | |
| N | 207V00000X | Obstetrics & Gynecology | MO | Allopathic & Osteopathic Physicians | |
| N | 213E00000X | Podiatrist | MO | Podiatric Medicine & Surgery Service Providers | |
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 501133607 | 05 |
| Other Name | Type Code |
|---|---|
| SSM Health Medical Group | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053616110 | Ssm Medical Group Inc. | Orthopaedic Surgery | 12349 De Paul Dr, Suite 100, Bridgeton, MO 63044 | 2011-01-21 |
| 1164581526 | Ssm Medical Group Inc. | Pharmacy | 711 Veterans Memorial Parkway, Suite 102, St. Chalres, MO 63303-2106 | 2006-12-08 |
| 1528503133 | Ssm Medical Group Inc. | Podiatrist | 172 Professional Pkwy, Troy, MO 63379 | 2017-01-05 |
| 1467997155 | Ssm Medical Group Inc. | Podiatrist | 722 N State Highway 47 Ste B, Warrenton, MO 63383 | 2017-01-04 |
| 1124579966 | Ssm Medical Group Inc. | Orthopaedic Surgery | 1011 Bowles Ave, Suite 400, Fenton, MO 63026-2395 | 2016-10-17 |
| 1063960409 | Ssm Medical Group Inc. | Orthopaedic Surgery | 816 S Kirkwood Rd, Suite 105, Saint Louis, MO 63122-6056 | 2016-09-14 |
| 1285004598 | Ssm Medical Group Inc. | Pain Medicine | 12255 Depaul Drive, Suite 120, Bridgeton, MO 63044 | 2015-09-29 |
| 1447633557 | Ssm Medical Group Inc. | Orthopaedic Surgery | 400 1st Capitol Dr, Suite 100, Saint Charles, MO 63301 | 2015-07-07 |
| 1437573920 | Ssm Medical Group Inc. | Orthopaedic Surgery | 1475 Kisker Rd, Suite 100, Saint Charles, MO 63304 | 2014-02-05 |
| 1043518350 | Ssm Medical Group Inc. | Orthopaedic Surgery | 1601 Wentzville Pkwy, Suite 117, Wentzville, MO 63385 | 2011-03-10 |
| Street Address |
1101 HIGHWAY K |
| City | O FALLON |
| State | MO |
| Zip Code | 63366 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407837982 | P Douglas Young Jr. | Obstetrics & Gynecology | 1101 Highway K, O Fallon, MO 63366-8431 | 2005-11-10 |
| 1407311228 | Jordan Green | Physical Therapist | 1101 Highway K, O Fallon, MO 63366-8431 | 2019-02-06 |
| 1649799065 | Nicole Gebhardt | Physical Therapist | 1101 Highway K, O Fallon, MO 63366-8431 | 2017-09-18 |
| 1376087437 | Kami Owenby | Nurse Practitioner | 1101 Highway K, O Fallon, MO 63366-8431 | 2016-12-08 |
| 1386186732 | Samantha L Branson | Nurse Practitioner | 1101 Highway K, O Fallon, MO 63366-8431 | 2016-11-15 |
| 1790239895 | Karin Derigne | Rehabilitation Unit | 1101 Highway K, O Fallon, MO 63366-8431 | 2016-08-08 |
| 1124490107 | Elizabeth Vollmar | Nurse Practitioner | 1101 Highway K, O Fallon, MO 63366-8431 | 2015-10-29 |
| 1659793883 | Ruth Turner | Nurse Practitioner | 1101 Highway K, O Fallon, MO 63366-8431 | 2014-01-07 |
| 1447696802 | Thomas Frederic Ganz | Obstetrics & Gynecology | 1101 Highway K, O Fallon, MO 63366-8431 | 2013-05-13 |
| 1790028520 | Lindsay Ann Murphy Dickerhoff | Obstetrics & Gynecology | 1101 Highway K, O Fallon, MO 63366-8431 | 2013-03-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407314826 | Transformative Health 180 LLC | Physical Therapist | 821 West Terra Lane, O Fallon, MO 63366 | 2019-03-05 |
| 1740754126 | Donna Marie Person | Nurse Practitioner | 331 Magnolia Valley Dr., Ofallon, MO 63366 | 2019-01-18 |
| 1679069470 | Samantha Schulte | Clinical Pharmacology | 7 Poor Richard Ct, O Fallon, MO 63366 | 2018-07-03 |
| 1790218048 | Jill Buery | Marriage & Family Therapist | 801 S Woodlawn Ave, Ste 15, O'fallon, MO 63366 | 2017-04-04 |
| 1114466968 | Jessica Anne Morris | Counselor | 103 Lincoln Street, O'fallon, MO 63366 | 2017-02-13 |
| 1639528540 | Kyle James Neuschaefer | Dentist | 31 Ofallon Sq, O Fallon, MO 63366 | 2016-06-10 |
| 1295116143 | Katherine Seiler Harkess | Obstetrics & Gynecology | 300 Winding Woods Drive Suite 200, O'fallon, MO 63366 | 2015-06-16 |
| 1528453354 | Amanda Flamm | Nurse Practitioner | 1101 Hightway K, Ofallon, MO 63366 | 2015-03-30 |
| 1144639972 | Sara Birkemeier | Physical Therapist | 1541 Norwood Hills Dr, Ofallon, MO 63366 | 2014-08-06 |
| 1710390893 | Catherine Rose Most | Speech-Language Pathologist | 555 E. Terra Lane, Fort Zumwalt School District, O'fallon, MO 63366 | 2014-06-06 |
| Find all providers in zip 63366 | ||||
| Taxonomy Code | 332B00000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient’s use in the home and that are usable for an extended period of time. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639553654 | Brian Randolph | Durable Medical Equipment & Medical Supplies | 1414 Sunburst Dr, O Fallon, MO 63366-3490 | 2015-07-20 |
| 1073860490 | Missouri Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 3002 Highway K, O Fallon, MO 63368-8675 | 2012-08-06 |
| 1447428347 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 4650 Hwy K, O Fallon, MO 63368-8728 | 2008-02-13 |
| 1992998256 | Signature Medical Group, Inc | Durable Medical Equipment & Medical Supplies | 20 Progress Point Parkway, Suite 106, O Fallon, MO 63368 | 2007-08-21 |
| 1730390550 | Mediequip, Inc | Durable Medical Equipment & Medical Supplies | 8640 Mexico Rd, O Fallon, MO 63366-7507 | 2007-05-24 |
| 1083833669 | Health Matters, LLC | Durable Medical Equipment & Medical Supplies | 1332 Norwood Hills Dr, O Fallon, MO 63366-5560 | 2007-04-24 |
| 1073520086 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 7422 Highway N, O Fallon, MO 63368-7013 | 2006-08-02 |
| 1437166444 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 9495 Mexico Rd, O Fallon, MO 63366-5547 | 2006-08-02 |
| 1508871773 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 704 Cambridge Blvd, O Fallon, IL 62269-1964 | 2006-07-29 |
| 1922013176 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 1490 Mexico Loop Rd E, O Fallon, MO 63366-6015 | 2006-07-29 |
| Find all providers in O FALLON | ||||
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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.