Mary C Livergood, M.D.

Primary specialty

Maternal & Fetal Medicine PhysicianTaxonomy code 207VM0101X

License

2022010786 Issued in MO

Practice address

3009 N Ballas Rd Ste 351C
Saint Louis, MO 63131-2324

Phone

(314) 996-6800

NPI assigned

Jun 17, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Mary Christine Graves Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WI, MO2 enrollments

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 2

Specialty

Obstetrics/Gynecology

Education

Creighton University School of Medicine, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Physician Groups LCGroup PAC ID 3072421254, 526 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Physician Groups LC

  • Multi-Specialty Clinic/Center
  • Saint Louis, MO
  • NPI 1285664268

  Obstetrics & Gynecology

  Medicare reassignment Care Compare group NPD
• The Medical College of Wisconsin, Inc.

  • Internal Medicine Physician
  • Milwaukee, WI
  • NPI 1699720086
  Medicare reassignment NPD
• Physician Groups LC

  • Multi-Specialty Clinic/Center
  • Farmington, MO
  • NPI 1427114990
  NPD

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

{
    "created_epoch": "1434499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659398400000",
    "number": "1093196842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3009 N BALLAS RD STE 351C",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631312324",
            "telephone_number": "314-996-6800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3009 N BALLAS RD STE 351C",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631312324",
            "telephone_number": "314-996-6800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9200 W Wisconsin Ave",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532263522",
            "country_code": "US",
            "telephone_number": "414-805-6600",
            "fax_number": "414-805-6622",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIVERGOOD",
        "first_name": "MARY",
        "middle_name": "C",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-17",
        "last_updated": "2022-08-02",
        "certification_date": "2022-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MO",
            "license": "2022010786",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "WI",
            "license": "70784",
            "primary": false
        },
        {
            "code": "207VM0101X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": "MO",
            "license": "2022010786",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1093196842",
            "state": "WI"
        }
    ],
    "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 351C",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631312324",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "GRAVES",
            "middle_name": "CHRISTINE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Live 2 Give in Home Healthcare LLC
• Live at Peace Ministries
• Live Better Now, Inc.
• Live Better Now, Inc.
• Cynthia Marie Lively, LCSW
• Christopher David Livesay, D.O.
• Living Essentials Consumer Directed Services LLC
• Living Essentials in Home Services LLC
• Living Life Long Residential Care
• Living Life Long, LLC

• Maternal & Fetal Medicine Physician in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Maternal & Fetal Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.