SIGNATURE MEDICAL GROUP, INC (NPI# 1255513784) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255513784 |
| Entity Type | Organization |
| Organization Name | SIGNATURE MEDICAL GROUP, INC |
| Practice Address |
12777 De Paul Drive Suite 305 Bridgeton MO 63044 |
| Mailing Address |
12639 Old Tesson Rd Suite 115 Saint Louis MO 63128-2786 |
| Practice Telephone | 3142913399 |
| Practice Fax Number | 3142913466 |
| Mailing Telephone | 3148490311 |
| Mailing Fax Number | 3148494423 |
| Enumeration Date | 2007-11-27 |
| Last Update Date | 2013-06-12 |
| Authorized Official Name | MR. 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 |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 621357706 | 05 |
| 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 |
| 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 |
| 1073904769 | Signature Medical Group, Inc | Durable Medical Equipment & Medical Supplies | 9323 Phoenix Village Pkwy, O Fallon, MO 63368-4281 | 2015-02-17 |
| 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 |
12777 DE PAUL DRIVE SUITE 305 |
| City | BRIDGETON |
| State | MO |
| Zip Code | 63044 |
| 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 |
| Find all providers in zip 63044 | ||||
| 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 |
|---|---|---|---|---|
| 1326558743 | Dan O Asewe | Durable Medical Equipment & Medical Supplies | 12106 Natural Bridge Rd Apt D, Bridgeton, MO 63044-2075 | 2017-10-11 |
| 1528491677 | Missouri Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 12380 Saint Charles Rock Rd, Bridgeton, MO 63044-2504 | 2013-08-13 |
| 1760539076 | Otto Bock Healthcare Lp | Durable Medical Equipment & Medical Supplies | 3430 J Mckelvey Rd, Ste M, Bridgeton, MO 63044-2556 | 2007-01-05 |
| 1144301359 | Leon Stotter Healthcare Services | Durable Medical Equipment & Medical Supplies | 65 Manheim Ave, Bridgeton, NJ 08302-2114 | 2006-10-17 |
| 1467551671 | Eckerd Corporation | Durable Medical Equipment & Medical Supplies | 1070 North Pearl Street, Bridgeton, NJ 08302-1215 | 2006-09-22 |
| 1740399161 | Rite Aid of New Jersey Inc | Durable Medical Equipment & Medical Supplies | 52 East Broad Street, Bridgeton, NJ 08302-2831 | 2006-08-30 |
| 1346257359 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 11404 Saint Charles Rock Rd, Bridgeton, MO 63044-2723 | 2006-08-02 |
| 1477568624 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 12345 Saint Charles Rock Rd, Bridgeton, MO 63044-2505 | 2006-07-29 |
| 1619994753 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 1130 Highway 77, Bridgeton, NJ 08302-5988 | 2006-07-16 |
| 1497772743 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 11900 Saint Charles Rock Rd, Bridgeton, MO 63044-2612 | 2006-07-16 |
| Find all providers in BRIDGETON | ||||
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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.