Generations Family Medicine PC
Organization Active NPI Family Medicine Physician · St Louis, MO
NPI 1023048907 · NPPES record last updated Dec 13, 2011
Key facts
- NPI
- 1023048907
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 2000154561 (MO)
- Legal business name
- GENERATIONS FAMILY MEDICINE PC
- Practice address
- 1035 Bellevue Ave
Suite 206
St Louis, MO 63117-1846 - Phone
- (314) 781-4922
- Fax
- (314) 645-0158
- NPI assigned
- Jul 4, 2006
- Organization subpart
- No
Authorized official
- Name
- Andrea A Baxter, M.D.
- Title
- President
- Phone
- (314) 781-4922
Practitioners 2
-
John D Radke, MD
-
Celso Ferreira Rodrigues, M.D.
National Provider Directory
Locations
1035 Bellevue Ave
Ste 206
Saint Louis, MO 63117
Phone (314) 781-4922
6125 Clayton Ave
Ste 410
Saint Louis, MO 63139
Phone (314) 768-3444
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | 2000154561 | MO | Yes |
Addresses
Primary practice location
1035 Bellevue Ave
Suite 206
St Louis, MO 63117-1846
Mailing address
1035 Bellevue Ave
Suite 206
St Louis, MO 63117-1846
Phone (314) 781-4922
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 509156709 | Medicaid | MO |
Other providers in St Louis, MO
- General Leonard Wood Army Community Hospital
- General Surgery of St Louis PC
- Generation Clinical Partners Aco, LLC
- Generation Clinical Partners LLC
- Generational Foundations LLC
- Genesis Adult Care, LLC
- Genesis Adult Care, LLC
- Genesis CDS, L.L.C
- Genesis Christian Counseling, LLC
- Genesis Enterprises Inc
All providers in St Louis, MO · Family Medicine Physician in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 13, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.