SSM MEDICAL GROUP INC. (NPI# 1124579966) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124579966 |
| Entity Type | Organization |
| Organization Name | SSM MEDICAL GROUP INC. |
| Other Organization Name | SSM HEALTH MEDICAL GROUP |
| Practice Address |
1011 Bowles Ave Suite 400 Fenton MO 63026-2395 |
| Mailing Address |
Po Box 955534 Saint Louis MO 63195-5534 |
| Practice Telephone | 6364965030 |
| Enumeration Date | 2016-10-17 |
| Last Update Date | 2020-08-18 |
| Authorized Official Name | KAREN REWERTS (VP FINANCIAL OPERATIONS) |
| Authorized Official Telephone | 3149892034 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207X00000X | Orthopaedic Surgery | Allopathic & Osteopathic Physicians | ||
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers |
| 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 |
| 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 |
| 1548578750 | Ssm Medical Group Inc. | Family Medicine | 1101 Highway K, O Fallon, MO 63366 | 2010-09-22 |
| Street Address |
1011 BOWLES AVE SUITE 400 |
| City | FENTON |
| State | MO |
| Zip Code | 63026-2395 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710979208 | Cesar Fernando Munoz | Internal Medicine | 1011 Bowles Ave, Ste. 300, Fenton, MO 63026-2395 | 2005-08-19 |
| 1083120208 | Tiffany Shanta Harold | Nurse Practitioner | 1011 Bowles Ave, Fenton, MO 63026-2395 | 2017-12-26 |
| 1093250334 | Laura Ann Rogers | Registered Nurse | 1011 Bowles Ave, Ste 220, Fenton, MO 63026-2395 | 2016-12-22 |
| 1699158196 | Diane Denise Block | Nurse Practitioner | 1011 Bowles Ave, Suite 300, Fenton, MO 63026-2395 | 2015-07-01 |
| 1992196992 | Tara Joann Knoepp | Physical Therapist | 1011 Bowles Ave, Suite 150, Fenton, MO 63026-2395 | 2015-02-11 |
| 1093129538 | Elizabeth Anne Rancour | Dermatology | 1011 Bowles Ave, Ste 121, Fenton, MO 63026 | 2014-06-12 |
| 1558799742 | Amanda Nicole Meitz | Nurse Practitioner | 1011 Bowles Ave, Suite 205, Fenton, MO 63026-2395 | 2013-10-24 |
| 1013253699 | Lita Lapins | Nurse Practitioner | 1011 Bowles Ave, Suite 300, Fenton, MO 63026 | 2012-12-30 |
| 1043568280 | Denise P Blackburn | Registered Nurse | 1011 Bowles Ave, Suite G10, Fenton, MO 63026-2395 | 2012-08-20 |
| 1013204692 | Center for Advanced Foot & Ankle Surgery, Inc. | Podiatrist | 1011 Bowles Ave, Suite 123, Fenton, MO 63026-2395 | 2011-07-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871000372 | Allison Egler | Audiologist | 1011 Bowles Ave Ste 405, Fenton, MO 63026 | 2018-01-05 |
| 1629508213 | Holly Brooks Munson | Massage Therapist | 220 Copper Mountain Dr, Fenton, MO 63026 | 2017-06-15 |
| 1073978862 | Naomi Sharon | Nurse Practitioner | 1101 Bowles Avenue, Suite G50, Fenton, MO 63026 | 2015-12-21 |
| 1871981704 | Celtic Private Care of Il & Mo, LLC | In Home Supportive Care | 1653 Larkin Williams Road, Suite 201, Fenton, MO 63026 | 2014-12-30 |
| 1356747513 | Kristina Potts | Nurse Practitioner | 774 Gravois Bluffs Blvd Ste B, Fenton, MO 63026 | 2014-11-14 |
| 1245642420 | Physicians Health Group Medical Inc | General Practice | 960 S. Highway Dr, Fenton, MO 63026 | 2014-05-22 |
| 1598047409 | Kevin Eugene Bruce | Pharmacist | 1210 Sugar Creek, Fenton, MO 63026 | 2011-09-16 |
| 1215186382 | Concentra Health Services, Inc. | Clinic/Center | 128 Matrix Commons Dr., Fenton, MO 63026 | 2008-09-15 |
| 1790954410 | Castlewood Treatment Center LLC | Community/Behavioral Health | 1855 Bowles Ave, Suite 210, Fenton, MO 63026 | 2008-02-27 |
| 1073703617 | Christina R Baeres | Dietitian, Registered | 38 Majestic Ct, Fenton, MO 63026 | 2007-07-30 |
| Find all providers in zip 63026 | ||||
| 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 |
|---|---|---|---|---|
| 1225556236 | Vital Hospital Systems, Inc | Durable Medical Equipment & Medical Supplies | 1763 Larkin Williams Rd, Fenton, MO 63026-2032 | 2017-08-30 |
| 1376721134 | Ex Press Medical Supply Inc | Durable Medical Equipment & Medical Supplies | 218 Seebold Spur, Fenton, MO 63026-4600 | 2008-02-04 |
| 1891970513 | Applied Ergonomics | Durable Medical Equipment & Medical Supplies | 1075 Headquarters Park, Fenton, MO 63026-1910 | 2007-12-31 |
| 1033390687 | Applied Ergonomics, LLC | Durable Medical Equipment & Medical Supplies | 1075 Headquarters Park Dr., Fenton, MO 63026-1910 | 2007-11-23 |
| 1578755849 | Genesys Health Enterprises Inc | Durable Medical Equipment & Medical Supplies | 425 N Fenway Dr, Suite C, Fenton, MI 48430-3810 | 2007-08-10 |
| 1902964232 | Hill-rom Company, Inc | Durable Medical Equipment & Medical Supplies | 1052 Cassens Industrial Ct, Fenton, MO 63026-2500 | 2006-12-06 |
| 1972684579 | Bemes Home Medical Inc | Durable Medical Equipment & Medical Supplies | 810 Sunpark Dr, Fenton, MO 63026-5388 | 2006-10-18 |
| 1841309309 | Perry Drug Stores Inc and Subsidiaries | Durable Medical Equipment & Medical Supplies | 2420 Owen Road, Mclaren Medical Center, Fenton, MI 48430-1769 | 2006-08-29 |
| 1730298290 | Apex Drug Stores Inc | Durable Medical Equipment & Medical Supplies | 1001 North Leroy Street, Fenton, MI 48430-2755 | 2006-08-29 |
| 1023023165 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 3270 W Silver Lake Rd, Fenton, MI 48430-1374 | 2006-07-29 |
| Find all providers in FENTON | ||||
Please comment or provide details below to improve the information on SSM MEDICAL GROUP INC..
| 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.