SSM MEDICAL GROUP (NPI# 1538342621) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1538342621 |
Entity Type | Organization |
Organization Name | SSM MEDICAL GROUP |
Other Organization Name | MARYVILLE PEDIATRICS |
Practice Address |
6828 State Route 162 Maryville IL 62062-8500 |
Mailing Address |
7980 Clayton Rd Suite 202 Saint Louis MO 63117-1354 |
Practice Telephone | 6182885084 |
Mailing Telephone | 3149515368 |
Enumeration Date | 2007-12-11 |
Last Update Date | 2007-12-11 |
Authorized Official Name | LESA SCHNARR (DIRECTOR) |
Authorized Official Telephone | 3149515330 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities |
Other Name | Type Code |
---|---|
Maryville Pediatrics | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1275781288 | Ssm Medical Group | Family Medicine | 1011 Bowles Ave, Suite 300, Fenton, MO 63026-2387 | 2008-09-03 |
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 |
6828 STATE ROUTE 162 |
City | MARYVILLE |
State | IL |
Zip Code | 62062-8500 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1700807187 | Habibur Rahman | Pediatrics | 6828 State Route 162, Suite A, Maryville, IL 62062-8500 | 2006-07-21 |
1851591523 | Jennifer Dawn Krick | Pediatrics | 6828 State Route 162, Maryville, IL 62062-8500 | 2007-07-20 |
1609964543 | Tri-city Neurology Associates, Ltd. | Psychiatry & Neurology | 6828 State Route 162, Maryville, IL 62062-8558 | 2006-10-10 |
1245345537 | Riaz A Naseer | Psychiatry & Neurology | 6828 State Route 162, Maryville, IL 62062-8558 | 2006-08-20 |
1750496055 | Syed S Ali | Psychiatry & Neurology | 6828 State Route 162, Maryville, IL 62062-8558 | 2006-08-20 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1104325091 | Jennifer M Oyler | Physician Assistant | 6812 State Route 162 Suite 120, Maryville, IL 62062 | 2018-02-06 |
1710495965 | Sarah Elizabeth Barto | Family Medicine | 2133 Vadalabene Drive, Suite Sb, Maryville, IL 62062 | 2018-01-22 |
1104348085 | Lindsey Nicole Langendorf | Chiropractor | 62 Executive Plaza Ct, Maryville, IL 62062 | 2017-07-12 |
1043750540 | Gina Saal | Nurse Anesthetist, Certified Registered | 6800 Rt 162, Maryville, IL 62062 | 2017-03-02 |
1548657737 | Karen Michelle Bertels | Emergency Medicine | 6800 Il - 162, Maryville, IL 62062 | 2015-04-25 |
1811258148 | Debra Ann Hoelscher | Internal Medicine | 2102 Vadalabene, Maryville, IL 62062 | 2012-06-04 |
1538438445 | Casey Elizabeth Wiesemeyer | Speech-Language Pathologist | 2201 Copper Creek Rd, Maryville, IL 62062 | 2011-12-21 |
1407144819 | Norah Claire Farley Baker | Family Medicine | 10 Professional Park Dr., Maryville, IL 62062 | 2011-07-19 |
1891092474 | Kimberly M Schneider | Physician Assistant | 20b Professional Park Drive, Maryville, IL 62062 | 2011-02-17 |
1669782397 | Purandhri Patel | Physical Therapist | 6820 State Route 162, Maryville, IL 62062 | 2010-10-15 |
Find all providers in zip 62062 |
Taxonomy Code | 261Q00000X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1811248628 | Barefoot Chiropractic LLC | Clinic/Center | 1406 N Mulberry St, Maryville, MO 64468-1157 | 2012-09-20 |
1881224707 | Mullock Health Care LLC | Clinic/Center | 2332 S Main St, Maryville, MO 64468-3622 | 2020-01-20 |
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1588261770 | Mount Sinai Community Foundation Dba Sinai Medical Group | Clinic/Center | 2701 W 68th St Fl 3, Chicago, IL 60629-1813 | 2020-10-01 |
1013514298 | Mount Sinai Community Foundation Dba Sinai Medical Group | Clinic/Center | 1500 S Fairfield Ave Fl 4, Chicago, IL 60608-1782 | 2020-10-01 |
1841804879 | Chicago Poly Clinic LLC | Clinic/Center | 2446 W Devon Ave, Chicago, IL 60659-1913 | 2020-09-08 |
1386258226 | Ortho Spine Surgical LLC | Clinic/Center | 1925 E 95th St Ste 220, Chicago, IL 60617-4710 | 2020-09-08 |
1821607425 | Desired Medical Services Incorporated | Clinic/Center | 371 Mackinaw Ave, Calumet City, IL 60409-2524 | 2020-07-29 |
1639787823 | Md Infusions, Pllc | Clinic/Center | 666 Dundee Rd Ste 1800, Northbrook, IL 60062-2727 | 2020-07-14 |
1407474083 | Staten Family Practice Pllc | Clinic/Center | 500 W Virginia Ave, Gillespie, IL 62033-1025 | 2020-07-09 |
1629696679 | Serenity Internal Medicine & Wellness Center | Clinic/Center | 3330 W 177th St # 2d-1, Hazel Crest, IL 60429-2184 | 2020-07-07 |
Find all providers with the same taxonomy |
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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.