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).
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 |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207T00000X | Neurological Surgery | Allopathic & Osteopathic Physicians |
Other Name | Type Code |
---|---|
DePaul Medical Group Neurosurgery | Doing Business As Name - Organization |
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 |
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 |
Street Address |
12255 DE PAUL DR SUITE 830 |
City | BRIDGETON |
State | MO |
Zip Code | 63044-2510 |
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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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 Code | 207T00000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Neurological Surgery |
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. |
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 |
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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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.