Individual provider Active NPI

Elizabeth P Hammer, M.D.

  • Pediatrics Physician
  • Union, MO
National Provider Identifier
1073540886
Registry record updated Jun 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
2003020132 Issued in MO
Practice address
1935 Prairie Dell Rd Ste 400
Union, MO 63084-4327
Phone
(636) 649-3085
Fax
(363) 649-3087
NPI assigned
Jun 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 2003020132 MO Primary

Addresses

Primary practice location

1935 Prairie Dell Rd Ste 400
Union, MO 63084-4327

Mailing address

PO Box 776084
Chicago, IL 60677-6084
Phone (636) 649-3085

Other practice location 1

97 Saint Andrews Dr
Union, MO 63084-4546
Phone (636) 583-2946

Other identifiers 1

IdentifierTypeStateIssuer
207243809MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050606000028 MO Practitioner - Pediatric Medicine 6901849587 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2003020132MOMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic East Communities Pediatrics Current Accepting new patients
Mercy Clinic East Communities Pediatrics CurrentSince Jul 1, 2012 Accepting new patients
Mercy Hospitals East Communities Past Accepting new patients

Locations

9513 Highway 100
New Haven, MO 63068
Phone (573) 237-6100

621 S New Ballas Rd
Ste 189A
Saint Louis, MO 63141
Phone (314) 251-6335

97 Saint Andrews Dr
Union, MO 63084
Phone (636) 583-2946

901 Patients First Dr
Washington, MO 63090
Phone (636) 239-7500

851 E 5th St
Ste 328
Washington, MO 63090
Phone (636) 239-1101

Interoperability endpoints

  • Direct secure messaging: ehammer76900@directc.mercy.net

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719187200000",
    "number": "1073540886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776084",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606776084",
            "telephone_number": "636-649-3085",
            "fax_number": "636-649-3087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1935 PRAIRIE DELL RD STE 400",
            "city": "UNION",
            "state": "MO",
            "postal_code": "630844327",
            "telephone_number": "636-649-3085",
            "fax_number": "363-649-3087"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "97 Saint Andrews Dr",
            "address_purpose": "LOCATION",
            "city": "Union",
            "state": "MO",
            "postal_code": "630844546",
            "country_code": "US",
            "telephone_number": "636-583-2946",
            "fax_number": "636-583-6131",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAMMER",
        "first_name": "ELIZABETH",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-27",
        "last_updated": "2024-06-24",
        "certification_date": "2024-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "2003020132",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "207243809",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Union, MO

Sources for this page

Verify at the official NPI Registry.