SSM DEPAUL MEDICAL GROUP, INC.


Address: 12255 De Paul Dr, Suite 830, Bridgeton, MO 63044-2510
Phone: 3142916556

SSM DEPAUL MEDICAL GROUP, INC. (NPI# 1154434736) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1154434736
Entity Type Organization
Organization Name SSM DEPAUL MEDICAL GROUP, INC.
Other Organization Name DEPAUL MEDICAL GROUP NEUROSURGERY
Practice Address 12255 De Paul Dr
Suite 830
Bridgeton
MO 63044-2510
Practice Telephone 3142916556
Mailing Telephone 3142916556
Enumeration Date 2006-08-16
Last Update Date 2020-08-22
Authorized Official Name MS. LAURA PULLUM (DIRECTOR OF PATIENT ACCOUNTS)
Authorized Official Telephone 3142098121
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207T00000X Neurological Surgery Allopathic & Osteopathic Physicians

Other Provider/Organization Names

Other Name Type Code
DePaul Medical Group Neurosurgery Doing Business As Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1639180631 Ssm Depaul Medical Group, Inc. Family Medicine 1821 Sherman Dr, Saint Charles, MO 63303-3984 2006-08-11
1073880480 Ssm Depaul Medical Group, Inc. Internal Medicine 2305 Georgia St, Louisiana, MO 63353-2559 2011-11-30
1003929407 Ssm Depaul Medical Group, Inc. Family Medicine 12255 De Paul Dr, Suite 200, Bridgeton, MO 63044-2510 2006-08-17
1174636575 Ssm Depaul Medical Group, Inc. Family Medicine 12255 De Paul Dr, Suite 600, Bridgeton, MO 63044-2510 2006-08-17
1881605905 Ssm Depaul Medical Group, Inc. Family Medicine 9068 Overland Plz, Overland, MO 63114-6122 2006-08-11
1376554345 Ssm Depaul Medical Group, Inc. Obstetrics & Gynecology 12277 De Paul Dr, Suite 403, Bridgeton, MO 63044-2516 2006-08-11
1952312951 Ssm Depaul Medical Group, Inc. Pediatrics 14021 New Halls Ferry Rd, Florissant, MO 63033-2708 2006-08-11
1760456743 Ssm Depaul Medical Group, Inc. Family Medicine 2024 Dorsett Vlg, Maryland Heights, MO 63043-2208 2006-02-15

Other Data Sources

Entity Type Entity Name Entity Address
System for Award Management (SAM) Entities SSM DEPAUL MEDICAL GROUP, INC. 10101 Woodfield Ln, Saint Louis, MO 63132-2937

Office Location

Street Address 12255 DE PAUL DR
SUITE 830
City BRIDGETON
State MO
Zip Code 63044-2510

Providers in the same location

NPI Name Taxonomy Address Enumeration
1588667497 Maria Mcfarland Podiatrist 12255 De Paul Dr, Suite 500, Bridgeton, MO 63044-2510 2005-05-24
1760846414 Rachel Heft Nurse Practitioner 12255 De Paul Dr, Suite 200, Bridgeton, MO 63044-2510 2016-04-08
1174983878 Angela R Berry Nurse Practitioner 12255 De Paul Dr, Ste 700, Bridgeton, MO 63044-2510 2016-02-24
1922478726 Darcy L Daniels Nurse Practitioner 12255 De Paul Dr, Suite 500, Bridgeton, MO 63044 2015-10-06
1821481474 Lindsey Rae Duncan Nurse Practitioner 12255 De Paul Dr, Suite 865, Bridgeton, MO 63044-2510 2015-03-06
1376884916 Comfort & Joy Home Health Care Agency Home Health 12255 De Paul Dr, Suite 45n, Bridgeton, MO 63044-2510 2013-03-06
1457604878 Mary F Hans Nurse Practitioner 12255 De Paul Dr, 320, Bridgeton, MO 63044-2510 2012-10-23
1073809141 Amy Colleen Mcclintock Family Medicine 12255 De Paul Dr, Suite 600, Bridgeton, MO 63044-2510 2011-06-27
1528227113 Eye Physicians of St Louis Ophthalmology 12255 De Paul Dr, Bridgeton, MO 63044-2510 2008-06-09
1790943728 Depaul Optical Technician/Technologist 12255 De Paul Dr, Bridgeton, MO 63044-2510 2008-05-27
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1073150017 Zoe Marie Wadsworth Nurse Practitioner 12255 Depaul Dr Suite 300, Bridgeton, MO 63044 2019-12-10
1609412451 Beyond Better, Best Home Health Care Services, Limited Liability Corpo In Home Supportive Care 3430 Mckelvey Road Ste B, Bridgeton, MO 63044 2019-11-26
1275189078 Delicate Angels Home Health LLC Home Health 11726 St. Charles Rock Road Suite G, Bridgeton, MO 63044 2019-08-16
1588210082 Nicholas Huber Physical Therapist 12349 Depaul Dr., Ste. 110, Bridgeton, MO 63044 2019-08-12
1124688858 Michelle Bassett Registered Nurse 11520 St. Charles Rock Rd., Suite 106, Bridgeton, MO 63044 2019-06-14
1336703883 Elena A Barrow Nurse Practitioner 12255 Depaul Dr, Suite 260, Bridgeton, MO 63044 2019-04-30
1487123105 Laura N Steiner Registered Nurse Gateway Pediatrics, Ltd, 12255 Depaul Drive, Suite 460 North Medical Building, Bridgeton, MO 63044 2018-11-26
1205310950 Danielle Mathis Nurse Practitioner 3440 Depaul Lane Suite 201, Bridgeton, MO 63044 2018-09-19
1588163570 Thoughts Out Loud Counseling, LLC Social Worker 11520 St. Charles Rock Road Suite 101, Bridgeton, MO 63044 2018-02-06
1912411430 Breanna Victoria Hayes Counselor 3165 Mckevley Road, Suite 200, Bridgeton, MO 63044 2017-11-20
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Taxonomy Information

Taxonomy Code 207T00000X
Grouping Allopathic & Osteopathic Physicians
Classification Neurological Surgery

Taxonomy Definition

A neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify function or activity of the nervous system; and the operative and non-operative management of pain. A neurological surgeon treats patients with disorders of the nervous system; disorders of the brain, meninges, skull, and their blood supply, including the extracranial carotid and vertebral arteries; disorders of the pituitary gland; disorders of the spinal cord, meninges, and vertebral column, including those which may require treatment by spinal fusion or instrumentation; and disorders of the cranial and spinal nerves throughout their distribution.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Neurological Surgery, 2007. http://www.abns.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Neurological Surgery.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1215182001 Ssm Neurosciences Inc Neurological Surgery 12255 Depaul Dr, Suite 830, Bridgeton, MO 63044 2008-11-21
1942322821 Victor G Williams II Neurological Surgery 12266 De Paul Dr Ste 100, Bridgeton, MO 63044-2541 2007-04-04
1023168101 North County Neurosurgery, Inc Neurological Surgery 12255 De Paul Dr, Suite 830, Bridgeton, MO 63044-2510 2007-01-11
1629043930 Christian W Sikorski Neurological Surgery 12266 De Paul Dr Ste 100, Bridgeton, MO 63044-2541 2006-02-21
1245203801 James J Lu Neurological Surgery 12255 De Paul Dr, Suite 830, Bridgeton, MO 63044-2510 2006-02-13
1760470462 Paul J Sheehan Neurological Surgery 12255 Depaul Drive, Suite 830, Bridgeton, MO 63044 2005-10-07

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1932752243 Regional Brain & Spine LLC Neurological Surgery 1617 East Malone, Sikeston, MO 63801-5021 2019-07-17
1518319136 Joseph Patrick Herbert Neurological Surgery One Hospital Drive, Dc048.00, Mc314 Mchaney Hall, Columbia, MO 65212 2016-07-07
1144571373 O. Gerald Orth Neurological Surgery 2404 Beachview Dr, Columbia, MO 65203-1409 2012-09-27
1013273580 Stephen J Johans Neurological Surgery 232 S Woods Mill Rd Ste 400, Chesterfield, MO 63017-3467 2012-04-09
1912276486 Paul Edward Stohr Neurological Surgery 2 Kirken Knoll Dr, Saint Louis, MO 63131-2310 2011-12-29
1275801896 George Emanuel Mendelsohn Neurological Surgery 24 Loren Woods, Saint Louis, MO 63124-1903 2011-12-09
1891080503 Olatilewa O Awe Neurological Surgery 802 N Riverside Rd Ste 150, Saint Joseph, MO 64507-2508 2011-06-10
1770802076 Aneela Darbar Neurological Surgery 3635 Vista Ave, Grand Blvd, Saint Louis, MO 63110-0250 2010-05-26
1114246543 Yusef I Mosley Neurological Surgery 4320 Wornall Rd Ste 2000, Kansas City, MO 64111-5941 2010-05-25
1639495922 Bartosz T Grobelny Neurological Surgery 4320 Wornall Rd Ste 710, Kansas City, MO 64111 2010-04-13
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Competitor

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City BRIDGETON
Zip Code 63044

Improve Information

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Dataset Information

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.

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