Organization Active NPI

MBS Advantage Inc

  • General Practice Physician
  • Saint Louis, MO
National Provider Identifier
1083612253
Registry record updated Mar 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
000014833 Issued in MO
Legal business name
MBS ADVANTAGE INC
Practice address
11618 Gravois Rd
Saint Louis, MO 63126-3014
Phone
(314) 842-1900
Fax
(314) 842-9185
NPI assigned
Jul 12, 2005
Last updated
Mar 11, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2012

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

Authorized official

Name
Ms. Jean L Foster, MA/CCC-SLP, BRS-SNPI 1972541233
Title
President
Phone
(314) 842-1900

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X 207927 IL
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X 000014833 MO Primary
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X 102623 MO
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X 146004057 IL

Addresses

Primary practice location

11618 Gravois Rd
Saint Louis, MO 63126-3014

Mailing address

11618 Gravois Rd
Saint Louis, MO 63126-3014
Phone (314) 842-1900

Other identifiers 3

IdentifierTypeStateIssuer
500893409MedicaidMO
121947OtherBCBS
271325663MedicaidIL

National Provider Directory

National Provider Directory

Locations

4618 N Illinois St
Fairview Heights, IL 62208
Phone (314) 510-3308

215 W Pennsylvania St
Staunton, IL 62088
Phone (618) 635-5577

100 Rosewood Village Dr
Swansea, IL 62226
Phone (618) 236-1391

11600 Concord Village Ave
Saint Louis, MO 63128
Phone (314) 842-1900

11600 Concord Village Ave
Ste 4
Saint Louis, MO 63128
Phone (314) 842-1900

11618 Gravois Rd
Saint Louis, MO 63126
Phone (314) 239-9740

Practitioners & affiliated clinicians

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1121126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331424000000",
    "number": "1083612253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11618 GRAVOIS RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631263014",
            "telephone_number": "314-842-1900",
            "fax_number": "314-842-9185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11618 GRAVOIS RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631263014",
            "telephone_number": "314-842-1900",
            "fax_number": "314-842-9185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MBS ADVANTAGE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-12",
        "last_updated": "2012-03-11",
        "status": "A",
        "authorized_official_last_name": "FOSTER",
        "authorized_official_first_name": "JEAN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "314-842-1900",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MA/CCC-SLP, BRS-S"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "IL",
            "license": "207927",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "MO",
            "license": "000014833",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "MO",
            "license": "102623",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146004057",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500893409",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "121947",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "271325663",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.