PHYSICIAN GROUPS LC (NPI# 1821164955) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821164955 |
| Entity Type | Organization |
| Organization Name | PHYSICIAN GROUPS LC |
| Other Organization Name | O FALLON FAMILY MEDICINE |
| Practice Address |
2630 Highway K O Fallon MO 63368-6624 |
| Mailing Address |
670 Mason Ridge Center Dr Suite 300 Saint Louis MO 63141-8573 |
| Practice Telephone | 6362405454 |
| Practice Fax Number | 6369805335 |
| Mailing Telephone | 3149967644 |
| Mailing Fax Number | 3149967658 |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2008-03-26 |
| Authorized Official Name | RAYMOND P DAVIDSON II (PRESIDENT) |
| Authorized Official Telephone | 3142862028 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| O Fallon Family Medicine | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033236948 | Physician Groups Lc | Allergy & Immunology | 301 West Washington Street, Suite 5, Farmington, MO 63640-1921 | 2007-03-23 |
| 1144357278 | Physician Groups Lc | Family Medicine | 1110 Wolfrum Rd, Weldon Spring, MO 63304-7796 | 2007-02-27 |
| 1427114990 | Physician Groups Lc | Clinic/Center | 1103 W Liberty, Farmington, MO 63640-1921 | 2006-12-29 |
| 1770650020 | Physician Groups Lc | Clinic/Center | 6 Jungermann Road, Suite 108, Saint Peters, MO 63376 | 2006-11-30 |
| 1679640007 | Physician Groups Lc | Clinic/Center | 3528 Patterson Rd, Florissant, MO 63031-1311 | 2006-11-29 |
| 1285664268 | Physician Groups Lc | Clinic/Center | 670 Mason Ridge Center Dr, Suite 300, Saint Louis, MO 63141-8573 | 2006-07-04 |
| 1750562542 | Physician Groups Lc | Obstetrics & Gynecology | 1 Barnes Jewish Hospital Plz, Ste. 16312, Saint Louis, MO 63110-1003 | 2007-11-20 |
| 1790978757 | Physician Groups Lc | Internal Medicine | 2 Progress Point Ct, Suite 101c, O Fallon, MO 63368-2208 | 2007-08-23 |
| 1043403009 | Physician Groups Lc | Obstetrics & Gynecology | 70 Jungermann Cir, Suite 101, Saint Peters, MO 63376-1622 | 2007-08-23 |
| 1598958787 | Physician Groups Lc | Colon & Rectal Surgery | 11155 Dunn Rd, Ste. 312e Bldg. 1, Saint Louis, MO 63136-6150 | 2007-08-22 |
| Street Address |
2630 HIGHWAY K |
| City | O FALLON |
| State | MO |
| Zip Code | 63368-6624 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083689061 | John J. O'brien | Family Medicine | 2630 Highway K, O Fallon, MO 63368-6624 | 2006-02-22 |
| 1558929471 | Stacey Elizabeth Brennan | Nurse Practitioner | 2630 Highway K, O Fallon, MO 63368-6624 | 2019-06-05 |
| 1336619782 | Mindy Marie Faraone | Nurse Practitioner | 2630 Highway K, O Fallon, MO 63368-6624 | 2018-11-28 |
| 1407243629 | Cassie Smith | Nurse Practitioner | 2630 Highway K, O Fallon, MO 63368-6624 | 2015-04-26 |
| 1366853541 | Gina Allen | Nurse Practitioner | 2630 Highway K, O Fallon, MO 63368-6624 | 2014-05-10 |
| 1043444342 | Ximena Soledad Schnurr | Family Medicine | 2630 Highway K, O Fallon, MO 63368-6624 | 2009-05-14 |
| 1316130503 | Physician Groups Lc | Orthopaedic Surgery | 2630 Highway K, O Fallon, MO 63368-6624 | 2007-08-22 |
| 1942377387 | Physician Groups Lc | Clinic/Center | 2630 Highway K, O Fallon, MO 63368-6624 | 2006-11-29 |
| 1043329105 | Amanda Heidemann | Family Medicine | 2630 Highway K, O Fallon, MO 63368-6624 | 2006-08-30 |
| 1508976523 | Liza Stanton | Family Medicine | 2630 Highway K, O Fallon, MO 63368-6624 | 2006-08-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134720329 | Come As You Are Counseling LLC | Counselor | 1001 Boardwalk Springs Place, Suite 111, O Fallon, MO 63368 | 2020-11-04 |
| 1770124802 | Lisa N. Greer | Technician | 6911 Brassel Dr., Ofallon, MO 63368 | 2019-09-30 |
| 1770145716 | Halie Faye Gulley | Dentist | 3009 Hwy K, O'fallon, MO 63368 | 2019-06-29 |
| 1972079556 | Erin Corsi Fraundorf | Dentist | 3009 State Hwy K, O'fallon, MO 63368 | 2018-10-22 |
| 1427579960 | Air Evac Ems, Inc. | Ambulance | 1001 Boardwalk Springs Pl Ste 250, O Fallon, MO 63368 | 2017-07-06 |
| 1528507472 | Washeck Manual Therapy LLC | Clinic/Center | 3074 Winghaven Blvd, O'fallon, MO 63368 | 2017-02-13 |
| 1639618457 | Brittany Hogan | Physical Therapist | 7412 South Outer 364, Suite B, Dardenne Prairie, MO 63368 | 2017-02-13 |
| 1124561469 | Cardinal Home Care LLC | Home Health | 18 Convent Garden Ct, O'fallon, MO 63368 | 2016-11-18 |
| 1336509272 | Sarah Marie Mudd | Counselor | 1654 Bryan Road, O'fallon, MO 63368 | 2016-03-04 |
| 1588023956 | Price-bourisaw Family Chiropractic | Chiropractor | 2917 State Highway K, O Fallon, MO 63368 | 2016-02-15 |
| Find all providers in zip 63368 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861706426 | Oleary Chiropractic Healing and Wellness | Clinic/Center | 2077 Floral Dr, O Fallon, MO 63368-6876 | 2010-08-05 |
| 1033350541 | Internal Medicine At Winghaven LLC | Clinic/Center | 5551 Winghaven Blvd Ste 290, O Fallon, MO 63368-3629 | 2009-03-12 |
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|---|---|---|---|---|
| 1174145668 | Essential Benefit Offerings, LLC | Clinic/Center | 1417 N Mount Auburn Rd Ste A2, Cape Girardeau, MO 63701-2171 | 2020-05-07 |
| 1114483468 | Your Optimal Healthcare LLC | Clinic/Center | 300 W 4th St Ste H, Eureka, MO 63025-1839 | 2019-02-12 |
| 1306313051 | Country Care Family Clinic, LLC | Clinic/Center | 3 E Cleveland Ave, Ellsinore, MO 63937 | 2018-10-31 |
| 1285118950 | Vera Whole Health, Wa PC | Clinic/Center | 8350 N. Church Road, Kansas City, MO 64158 | 2018-09-19 |
| 1003324542 | Quad/med, LLC | Clinic/Center | 2015 Ne Jefferson Street, Grain Valley, MO 64029 | 2018-01-18 |
| 1093267601 | Careatc-saint Peter | Clinic/Center | 4601 Executive Centre Pkwy, Saint Peters, MO 63376-1683 | 2016-10-30 |
| 1407303480 | Kerns Family Health Care LLC | Clinic/Center | 1335 Vilage Dr B, St. Joseph, MO 64506-2457 | 2016-09-07 |
| 1316491020 | Wecare Tlc - Wwt Mo Family Health Center | Clinic/Center | 58 Weldon Pkwy, Bldg 58, Maryland Heights, MO 63043-3237 | 2016-08-10 |
| 1255703500 | Community Hospital Association | Clinic/Center | 101 South Washington Street, Oregon, MO 64473 | 2015-10-27 |
| 1023485752 | Dennis E. Robinson D.o. | Clinic/Center | 487 Pomme De Terre Dr., Marshfield, MO 65706 | 2015-08-28 |
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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.