SSM MEDICAL GROUP INC. (NPI# 1285004598) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285004598 |
| Entity Type | Organization |
| Organization Name | SSM MEDICAL GROUP INC. |
| Other Organization Name | SSM HEALTH MEDICAL GROUP |
| Practice Address |
12255 Depaul Drive Suite 120 Bridgeton MO 63044 |
| Mailing Address |
3221 Mckelvey Rd Ste 301 Bridgeton MO 63044-2551 |
| Practice Telephone | 3142917900 |
| Mailing Telephone | 6364985944 |
| Mailing Fax Number | 3142098127 |
| Enumeration Date | 2015-09-29 |
| Last Update Date | 2018-10-19 |
| Authorized Official Name | BRIDGET EDER (PROVIDER ENROLLMENT SPECIALIST) |
| Authorized Official Telephone | 6364985944 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208VP0000X |
Pain Medicine Specialization: Pain Medicine |
Allopathic & Osteopathic Physicians | ||
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers |
| Other Name | Type Code |
|---|---|
| SSM Health Medical Group | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053616110 | Ssm Medical Group Inc. | Orthopaedic Surgery | 12349 De Paul Dr, Suite 100, Bridgeton, MO 63044 | 2011-01-21 |
| 1164581526 | Ssm Medical Group Inc. | Pharmacy | 711 Veterans Memorial Parkway, Suite 102, St. Chalres, MO 63303-2106 | 2006-12-08 |
| 1528503133 | Ssm Medical Group Inc. | Podiatrist | 172 Professional Pkwy, Troy, MO 63379 | 2017-01-05 |
| 1467997155 | Ssm Medical Group Inc. | Podiatrist | 722 N State Highway 47 Ste B, Warrenton, MO 63383 | 2017-01-04 |
| 1124579966 | Ssm Medical Group Inc. | Orthopaedic Surgery | 1011 Bowles Ave, Suite 400, Fenton, MO 63026-2395 | 2016-10-17 |
| 1063960409 | Ssm Medical Group Inc. | Orthopaedic Surgery | 816 S Kirkwood Rd, Suite 105, Saint Louis, MO 63122-6056 | 2016-09-14 |
| 1447633557 | Ssm Medical Group Inc. | Orthopaedic Surgery | 400 1st Capitol Dr, Suite 100, Saint Charles, MO 63301 | 2015-07-07 |
| 1437573920 | Ssm Medical Group Inc. | Orthopaedic Surgery | 1475 Kisker Rd, Suite 100, Saint Charles, MO 63304 | 2014-02-05 |
| 1043518350 | Ssm Medical Group Inc. | Orthopaedic Surgery | 1601 Wentzville Pkwy, Suite 117, Wentzville, MO 63385 | 2011-03-10 |
| 1548578750 | Ssm Medical Group Inc. | Family Medicine | 1101 Highway K, O Fallon, MO 63366 | 2010-09-22 |
| Street Address |
12255 DEPAUL DRIVE SUITE 120 |
| City | BRIDGETON |
| State | MO |
| Zip Code | 63044 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912905134 | Marco A Castaneda | Surgery | 12255 Depaul Drive, #675n, Bridgeton, MO 63044 | 2005-07-12 |
| 1699305334 | Lisa Marie Schuster | Registered Nurse | 12255 Depaul Drive, Suite 600, Bridgeton, MO 63044-2515 | 2020-01-22 |
| 1851942874 | Audiology Consultants, LLC | Audiologist | 12255 Depaul Drive, Suite 860 North, Bridgeton, MO 63044 | 2019-09-20 |
| 1437611720 | Hannan Zahid | Student in an Organized Health Care Education/Training Program | 12255 Depaul Drive, Bridgeton, MO 63044 | 2019-04-04 |
| 1174028195 | North County Internists Inc | Internal Medicine | 12255 Depaul Drive, Suite 260, Bridgeton, MO 63044-2510 | 2018-03-30 |
| 1043719404 | Shannon Marie Lefler | Student in an Organized Health Care Education/Training Program | 12255 Depaul Drive, Suite 860 North, Bridgeton, MO 63044-2515 | 2018-02-12 |
| 1275046773 | George Dermatology, LLC | Dermatology | 12255 Depaul Drive, 770 North Building, Bridgeton, MO 63044-2515 | 2017-11-07 |
| 1053822254 | Amy Elizabeth Mcalister | Nurse Practitioner | 12255 Depaul Drive, Suite 370, Bridgeton, MO 63044 | 2017-10-16 |
| 1356872089 | Kristy A Thomas | Dietitian, Registered | 12255 Depaul Drive, Ste 420, Bridgeton, MO 63044-2510 | 2017-03-24 |
| 1700268331 | Elin Cogan-adewunmi | Social Worker | 12255 Depaul Drive, Suite 500, Bridgeton, MO 63044 | 2015-06-19 |
| Find all providers in the same location | ||||
| 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 |
| 1255513784 | Signature Medical Group, Inc | Durable Medical Equipment & Medical Supplies | 12777 De Paul Drive, Suite 305, Bridgeton, MO 63044 | 2007-11-27 |
| 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 |
| 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.