SIGNATURE MEDICAL GROUP, INC (NPI# 1073904769) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073904769 |
| Entity Type | Organization |
| Organization Name | SIGNATURE MEDICAL GROUP, INC |
| Practice Address |
9323 Phoenix Village Pkwy O Fallon MO 63368-4281 |
| Mailing Address |
12639 Old Tesson Rd Saint Louis MO 63128-2786 |
| Practice Telephone | 6365610871 |
| Practice Fax Number | 6365610875 |
| Mailing Telephone | 3148490311 |
| Mailing Fax Number | 3148494423 |
| Enumeration Date | 2015-02-17 |
| Last Update Date | 2015-02-17 |
| Authorized Official Name | JAN VEST (CEO) |
| Authorized Official Telephone | 3148490311 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235430851 | Signature Medical Group, Inc | Family Medicine | 2010 S Arlington Heights Rd Ste 110, Arlington Heights, IL 60005-4100 | 2010-11-12 |
| 1255513784 | Signature Medical Group, Inc | Durable Medical Equipment & Medical Supplies | 12777 De Paul Drive, Suite 305, Bridgeton, MO 63044 | 2007-11-27 |
| 1992998256 | Signature Medical Group, Inc | Durable Medical Equipment & Medical Supplies | 20 Progress Point Parkway, Suite 106, O Fallon, MO 63368 | 2007-08-21 |
| 1609269919 | Signature Medical Group, Inc | Durable Medical Equipment & Medical Supplies | 5301 Veterans Memorial Pkwy, Suite 104, Saint Peters, MO 63376-2298 | 2015-03-11 |
| 1023435534 | Signature Medical Group, Inc | Durable Medical Equipment & Medical Supplies | 7345 Watson Rd, Suite Ll3, Saint Louis, MO 63119-4405 | 2014-03-21 |
| 1396907614 | Signature Medical Group, Inc | Durable Medical Equipment & Medical Supplies | 1165 N Butterfield Rd, Bolivar, MO 65613-1056 | 2008-06-27 |
| 1255477469 | Signature Medical Group, Inc | Durable Medical Equipment & Medical Supplies | 1027 Bellevue Ave, Suite 25, Saint Louis, MO 63117-1851 | 2007-01-29 |
| 1124164942 | Signature Medical Group, Inc | Durable Medical Equipment & Medical Supplies | 621 S New Ballas Rd, Suite 63b, Saint Louis, MO 63141-8232 | 2007-01-29 |
| 1649201864 | Signature Medical Group, Inc | Durable Medical Equipment & Medical Supplies | 12639 Old Tesson Rd, Suite 115, Saint Louis, MO 63128-2786 | 2006-07-05 |
| 1871542761 | Signature Medical Group, Inc | Allergy & Immunology | 12639 Old Tesson Rd, Suite 115, Saint Louis, MO 63128-2786 | 2006-05-08 |
| Street Address |
9323 PHOENIX VILLAGE PKWY |
| City | O FALLON |
| State | MO |
| Zip Code | 63368-4281 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205839354 | Emil A Difilippo | Orthopaedic Surgery | 9323 Phoenix Village Pkwy, O Fallon, MO 63366-4281 | 2005-05-23 |
| 1447454103 | Kevin James Quigley | Orthopaedic Surgery | 9323 Phoenix Village Pkwy, O Fallon, MO 63368-4281 | 2007-06-14 |
| 1437264595 | Jeffrey Steven Boberg | Podiatrist | 9323 Phoenix Village Pkwy, O Fallon, MO 63368-4281 | 2006-08-20 |
| 1174561211 | Matthew Paul Melander | Orthopaedic Surgery | 9323 Phoenix Village Pkwy, O Fallon, MO 63368-4281 | 2006-06-02 |
| 1275536120 | James E Schaberg | Orthopaedic Surgery | 9323 Phoenix Village Pkwy, O Fallon, MO 63366-4281 | 2005-05-24 |
| 1710980750 | Mark K Keohane | Orthopaedic Surgery | 9323 Phoenix Village Pkwy, O Fallon, MO 63366-4281 | 2005-05-23 |
| 1710980875 | Anthony J Berni | Orthopaedic Surgery | 9323 Phoenix Village Pkwy, O Fallon, MO 63366-4281 | 2005-05-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134720329 | Come As You Are Counseling LLC | Counselor | 1001 Boardwalk Springs Place, Suite 111, O Fallon, MO 63368 | 2020-11-04 |
| 1770124802 | Lisa N. Greer | Technician | 6911 Brassel Dr., Ofallon, MO 63368 | 2019-09-30 |
| 1770145716 | Halie Faye Gulley | Dentist | 3009 Hwy K, O'fallon, MO 63368 | 2019-06-29 |
| 1972079556 | Erin Corsi Fraundorf | Dentist | 3009 State Hwy K, O'fallon, MO 63368 | 2018-10-22 |
| 1427579960 | Air Evac Ems, Inc. | Ambulance | 1001 Boardwalk Springs Pl Ste 250, O Fallon, MO 63368 | 2017-07-06 |
| 1528507472 | Washeck Manual Therapy LLC | Clinic/Center | 3074 Winghaven Blvd, O'fallon, MO 63368 | 2017-02-13 |
| 1639618457 | Brittany Hogan | Physical Therapist | 7412 South Outer 364, Suite B, Dardenne Prairie, MO 63368 | 2017-02-13 |
| 1124561469 | Cardinal Home Care LLC | Home Health | 18 Convent Garden Ct, O'fallon, MO 63368 | 2016-11-18 |
| 1336509272 | Sarah Marie Mudd | Counselor | 1654 Bryan Road, O'fallon, MO 63368 | 2016-03-04 |
| 1588023956 | Price-bourisaw Family Chiropractic | Chiropractor | 2917 State Highway K, O Fallon, MO 63368 | 2016-02-15 |
| Find all providers in zip 63368 | ||||
| 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.