SSM MEDICAL GROUP (NPI# 1275781288) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275781288 |
| Entity Type | Organization |
| Organization Name | SSM MEDICAL GROUP |
| Other Organization Name | FAMILY PRACTICE OF SOUTH COUNTY |
| Practice Address |
1011 Bowles Ave Suite 300 Fenton MO 63026-2387 |
| Mailing Address |
10777 Sunset Office Dr Suite 310 Saint Louis MO 63127-1019 |
| Practice Telephone | 6364965000 |
| Practice Fax Number | 6364965055 |
| Mailing Telephone | 3148225900 |
| Mailing Fax Number | 3148225919 |
| Enumeration Date | 2008-09-03 |
| Last Update Date | 2009-07-08 |
| Authorized Official Name | JAMES E BIESER (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 3148225900 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Family Practice of South County | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538342621 | Ssm Medical Group | Clinic/Center | 6828 State Route 162, Maryville, IL 62062-8500 | 2007-12-11 |
| 1619150703 | Ssm Medical Group | Clinic/Center | 3 Park Pl, Swansea, IL 62226-2965 | 2007-12-11 |
| 1144402660 | Ssm Medical Group | Clinic/Center | 1031 Bellevue Ave, Suite 300, Saint Louis, MO 63117-1818 | 2007-11-27 |
| 1053593541 | Ssm Medical Group | Clinic/Center | 1035 Bellevue Ave, Suite 502, Saint Louis, MO 63117-1854 | 2007-11-27 |
| 1013199504 | Ssm Medical Group | Clinic/Center | 1035 Bellevue Ave, Suite 305, Saint Louis, MO 63117-1854 | 2007-11-27 |
| 1760663447 | Ssm Medical Group | Clinic/Center | 6400 Clayton Rd, Suite 216, Saint Louis, MO 63117-1850 | 2007-11-21 |
| 1023297637 | Ssm Medical Group | Pediatrics | 4116 Von Talge Rd, Saint Louis, MO 63128-1957 | 2007-10-31 |
| 1649459215 | Ssm Medical Group | Clinic/Center | 20 The Legends Pkwy, Suite 100, Eureka, MO 63025-3821 | 2007-10-30 |
| 1023218898 | Ssm Medical Group | Internal Medicine | 1011 Bowles Ave, Suite 300, Fenton, MO 63026-2387 | 2007-07-20 |
| 1770789984 | Ssm Medical Group | Clinic/Center | 1747 Smizer Station Rd, Suite 6, Fenton, MO 63026-2784 | 2007-06-25 |
| Street Address |
1011 BOWLES AVE SUITE 300 |
| City | FENTON |
| State | MO |
| Zip Code | 63026-2387 |
| 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 |
| 1124579966 | Ssm Medical Group Inc. | Orthopaedic Surgery | 1011 Bowles Ave, Suite 400, Fenton, MO 63026-2395 | 2016-10-17 |
| 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 |
| 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 | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699328914 | Alegis Care - Michigan PC | Family Medicine | 1400 S Highway Dr Ste 200, Fenton, MO 63026-2281 | 2019-07-17 |
| 1518438688 | Flash Care Pllc | Family Medicine | 17100 Silver Pkwy Ste B, Fenton, MI 48430-3468 | 2018-12-16 |
| 1396163390 | Kyleigh Naismith | Family Medicine | 2420 Owen Rd Ste A, Fenton, MI 48430-3417 | 2014-04-07 |
| 1447492376 | Homebound Healthcare LLC | Family Medicine | 1076 Stone Bluff Dr, Fenton, MO 63026-8515 | 2009-03-24 |
| 1417079377 | Medcare Physician LLC | Family Medicine | 2117 Bentley Plaza, Fenton, MO 63026 | 2007-04-04 |
| 1811014491 | Joseph Lavern Trollman Jr. | Family Medicine | 201 E Caroline St, Fenton, MI 48430-2105 | 2007-03-26 |
| 1073670154 | Donna Smith Benford | Family Medicine | 1100 Torrey Rd Ste 300, Fenton, MI 48430-3327 | 2007-01-02 |
| 1194827857 | Susan H Longe | Family Medicine | 435 N Leroy St, Fenton, MI 48430-2731 | 2006-09-02 |
| 1235231077 | James S Garfield | Family Medicine | 17100 Silver Pkwy, Ste D, Fenton, MI 48430-3468 | 2006-09-02 |
| 1801998513 | Shawndra Latoya Brown-foote | Family Medicine | 128 Matrix Commons Dr, Fenton, MO 63026-2935 | 2006-09-02 |
| Find all providers in FENTON | ||||
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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.