NPIMap

Organization Active NPI

Cep America LLC

  • Emergency Medicine Physician
  • Fenton, MO
National Provider Identifier
1093360414
Registry record updated Apr 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
CEP AMERICA LLC
Practice address
1015 Bowles Ave
Fenton, MO 63026-2394
Phone
(636) 496-2000
NPI assigned
Aug 2, 2019
Last updated
Apr 1, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2020

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

Authorized official

Name
David Birdsall, M.DNPI 1164445615
Title
C.O.O
Phone
(510) 350-2600

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207P00000X Primary

Addresses

Primary practice location

1015 Bowles Ave
Fenton, MO 63026-2394

Mailing address

1601 Cummins Dr Ste D
Modesto, CA 95358-6411
Phone (510) 350-2638

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150312000325 MO Part B Supplier - Clinic/Group Practice 6608056171 Receives reassigned benefits from 337 practitioners
9 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Saint Charles, MO; Wentzville, MO; Saint Louis, MO; Richmond Heights, MO; Lake Saint Louis, MO; Fenton, MO; Bridgeton, MO

Other NPIs on the same Medicare enrollment 9

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 35

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 35

NPI Registry JSON

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

{
    "created_epoch": "1564704000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1585699200000",
    "number": "1093360414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 CUMMINS DR STE D",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953586411",
            "telephone_number": "510-350-2638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 BOWLES AVE",
            "city": "FENTON",
            "state": "MO",
            "postal_code": "630262394",
            "telephone_number": "636-496-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CEP AMERICA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-02",
        "last_updated": "2020-04-01",
        "certification_date": "2020-04-01",
        "status": "A",
        "authorized_official_last_name": "BIRDSALL",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "C.O.O",
        "authorized_official_telephone_number": "510-350-2600",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fenton, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.