MERCY CLINIC EAST COMMUNITIES


Address: 16555 Manchester Rd Ste 110, Wildwood, MO 63040-1220
Phone: 6364053155

MERCY CLINIC EAST COMMUNITIES (NPI# 1164857397) 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) 1164857397
Entity Type Organization
Organization Name MERCY CLINIC EAST COMMUNITIES
Other Organization Name MERCY CLINIC CONVENIENT CARE
Practice Address 16555 Manchester Rd Ste 110
Wildwood
MO 63040-1220
Practice Telephone 6364053155
Practice Fax Number 6364053162
Mailing Telephone 6364053155
Mailing Fax Number 6364053162
Enumeration Date 2013-09-06
Last Update Date 2018-03-17
Authorized Official Name DR. JOHN W. HUBERT (PRESIDENT)
Authorized Official Telephone 3142516000
Authorized Official Credential M.D.
Is Organization Subpart Y
Parent Organization Name MERCY HEALTH EAST COMMUNITIES

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QM1300X Clinic/Center
Specialization: Multi-Specialty
Ambulatory Health Care Facilities

Other Provider Identifier

State Issuer Identifier Type Code
MO 1164857397 05

Other Provider/Organization Names

Other Name Type Code
Mercy Clinic Convenient Care Other Name - Individual/Organization

Provider Secondary Practice Location

Address Telephone Number Fax Number
4525 Mid Rivers Mall Dr Ste 10, Cottleville, MO 633762820 6362293350 6362293355
901 Patients First Dr Ste 1200, Washington, MO 630904700 6363901777 6363901778

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1720635329 Mercy Clinic East Communities Family Medicine 10004 Kennerly Rd Ste 395b, Saint Louis, MO 63128-2190 2019-08-20
1235493776 Mercy Clinic East Communities Clinic/Center 125 N Old Highway 66, Bourbon, MO 65441-6298 2012-06-29
1700370061 Mercy Clinic East Communities Internal Medicine 15945 Clayton Rd Ste 310, Ballwin, MO 63011-2493 2018-06-20
1285998724 Mercy Clinic East Communities Clinic/Center 301 Theresa St, Cuba, MO 65453-1636 2012-06-29
1467716928 Mercy Clinic East Communities Clinic/Center 101 Progress Pkwy, Sullivan, MO 63080-2359 2012-06-29
1619231164 Mercy Clinic East Communities Clinic/Center 520 Pine St, Steelville, MO 65565-6041 2012-06-29
1043574940 Mercy Clinic East Communities Allergy & Immunology 615 S New Ballas Rd, Administration Building, 5th Floor, Saint Louis, MO 63141-8221 2012-06-26
1073739041 Mercy Clinic East Communities Family Medicine 615 S New Ballas Rd, Administrative Building, 5th Floor, Saint Louis, MO 63141-8221 2007-04-18
1851335228 Mercy Clinic East Communities Family Medicine 615 S New Ballas Rd, Administration Building, 5th Floor, Saint Louis, MO 63141-8221 2006-06-16

Other Data Sources

Entity Type Entity Name Entity Address
System for Award Management (SAM) Entities MERCY CLINIC EAST COMMUNITIES 645 Maryville Centre Dr, Saint Louis, MO 63141-5855

Office Location

Street Address 16555 MANCHESTER RD STE 110
City WILDWOOD
State MO
Zip Code 63040-1220

Providers in the same location

NPI Name Taxonomy Address Enumeration
1619332608 Tonnya Marie Taggart Nurse Practitioner 16555 Manchester Rd Ste 110, Wildwood, MO 63040 2015-12-18

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1154959336 Jacquelyn M Mellis Social Worker 2634 Hwy 109, Suite E, Wildwood, MO 63040 2020-04-01
1710359484 Dierbergs Town Center Pharmacy Pharmacy 2460 Taylor Road, Wildwood, MO 63040 2015-10-21
1295175057 Devin Willis Family Medicine 16555 Manchester Rd Ste 100, Wildwood, MO 63040 2013-06-26
1265748248 Mary K Bland Speech-Language Pathologist 251 Plaza Dr, Wildwood, MO 63040 2010-08-27
1871726067 Wildwood Internal Medicine, PC Internal Medicine 16759 Main Street, Suite 203, Wildwood, MO 63040 2009-09-03
1730274853 Seth P Freedman Dentist 16920 Manchester Road, Wildwood, MO 63040 2006-10-04
1477927556 Forefront Dermatology, S.c. Dermatology 16516 Manchester Rd, Wildwood, MO 63040 2015-11-30
1881953784 Glennia J Chitwood Chiropractor 16925 Manchester Rd, Suite 1, Wildwood, MO 63040 2012-05-11
1649363888 Michael Paul Van Horenbeeck Chiropractor 16917 Manchester Rd, Wildwood, MO 63040 2006-10-02
1699314880 Lauren Alison Medina Chiropractor 17197 New College Ave, Wildwood, MO 63040-1100 2020-01-05
Find all providers in zip 63040

Taxonomy Information

Taxonomy Code 261QM1300X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Multi-Specialty

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1922575802 Lakewood Ccl, LLC Clinic/Center 5571 E Sr 44 Ste 501, Wildwood, FL 34785-8282 2018-10-29

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1023629458 Palm Valley Health LLC Clinic/Center 1095 Nooning Tree Dr, Chesterfield, MO 63017-2468 2020-08-10
1477175594 Confident American English, LLC Clinic/Center 1190 Jefferson St Ste 103a, Washington, MO 63090-4443 2020-05-12
1619513215 Southeast Missouri Health Network Clinic/Center 835 W Murray Ln, Sikeston, MO 63801-4056 2019-11-19
1275014953 Arch Pediatrics LLC Clinic/Center 3844 S Lindbergh Blvd Ste 216, Saint Louis, MO 63127-1369 2018-08-22
1174015515 Washington University Physicians In Illinois, Inc Clinic/Center 4511 Forest Park Ave, Saint Louis, MO 63108-2138 2018-06-01
1164921300 Texas County Memorial Hospital Clinic/Center 1333 S Sam Houston Blvd Ste A, Houston, MO 65483 2018-02-02
1053822650 Edge Medical Services Inc. Clinic/Center 105 W 34th St Apt 2, Kansas City, MO 64111-1677 2017-10-23
1932618394 United Physicians Group, LLC Clinic/Center 14825 N Outer 40 Rd Ste 365, Chesterfield, MO 63017-2152 2017-09-28
1073022000 Fairview Heights Medical Group Sc Clinic/Center 670 Mason Ridge Center Dr Ste 300, Saint Louis, MO 63141-8573 2017-09-21
1013433762 Elevating Care Clinic, LLC Clinic/Center 2340 E. Meyer Blvd, 208, Kansas City, MO 64132-1105 2017-08-15
Find all providers with the same taxonomy

Competitor

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City WILDWOOD
Zip Code 63040

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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