NPIMap

Individual provider Active NPI

Mark Charles Howard, MD

  • Family Medicine Physician
  • Saint Louis, MO
National Provider Identifier
1073586848
Registry record updated Mar 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2004028837 Issued in MO
Practice address
3009 N Ballas Rd Ste 387C
Saint Louis, MO 63131-2324
Phone
(314) 996-5900
Fax
(314) 996-5910
NPI assigned
Feb 10, 2006
Last updated
Mar 4, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2004028837 MO Primary

Addresses

Primary practice location

3009 N Ballas Rd Ste 387C
Saint Louis, MO 63131-2324

Mailing address

3009 N Ballas Rd Ste 387C
Saint Louis, MO 63131-2324
Phone (314) 996-5900

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Health Information Exchange (HIE)

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050816001047 MO Practitioner - Family Practice 2668402942 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Medical College of Wisconsin, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
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Aging Well Health Care, LLCGroup PAC ID 1153232038, 236 clinicians

Practice addresses (Care Compare)

1110 Highlands Plaza Dr E
Saint Louis, MO 63110-1351
Phone (314) 273-0195

12788 Olive Blvd
Creve Coeur, MO 63141-6211

2630 Hwy K
O Fallon, MO 63368-6624
Phone (636) 240-5454

3009 N Ballas Rd
Saint Louis, MO 63131-2322

7212 Balson Ave
Saint Louis, MO 63130-3001

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2004028837MOMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Physician Groups LC Family Medicine CurrentSince Sep 1, 2018 Accepting new patients
Physician Groups LC CurrentSince Sep 1, 2018 Accepting new patients
SSM Health Care St. Louis Past Accepting new patients

Locations

2630 Highway K
O Fallon, MO 63368
Phone (636) 240-5454

3009 N Ballas Rd
Ste 387C
Saint Louis, MO 63131
Phone (314) 996-5900

Interoperability endpoints

  • Direct secure messaging: mhoward625819@direct.carenet.org

Organizations & group practices 5

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

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1139529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614816000000",
    "number": "1073586848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3009 N BALLAS RD STE 387C",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631312324",
            "telephone_number": "314-996-5900",
            "fax_number": "314-996-5910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3009 N BALLAS RD STE 387C",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631312324",
            "telephone_number": "314-996-5900",
            "fax_number": "314-996-5910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOWARD",
        "first_name": "MARK",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-10",
        "last_updated": "2021-03-04",
        "certification_date": "2021-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2004028837",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "BJC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3009 N Ballas Rd Ste 387C",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631312324",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.