Individual provider Active NPI

Mary Shaughnessy Meyer, MD

  • Pediatrics Physician
  • Saint Louis, MO
National Provider Identifier
1144257262
Registry record updated Apr 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
2006006810 Issued in MO
Practice address
4488 Forest Park Ave
Ste 230
Saint Louis, MO 63108-2283
Phone
(314) 535-7855
Fax
(314) 534-2803
NPI assigned
Jun 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2025

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 2006006810 MO Primary

Addresses

Primary practice location

4488 Forest Park Ave
Ste 230
Saint Louis, MO 63108-2283

Mailing address

PO Box 7412021
Chicago, IL 60674-2021
Phone (314) 535-7855

Other identifiers 1

IdentifierTypeStateIssuer
200968204MedicaidMO

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Washington University

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2006006810MOMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Washington Univ Clinical Associates Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: mmeyer154691@direct.carenet.org

Organizations & group practices 1

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": "1151280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744934400000",
    "number": "1144257262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7412021",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606742021",
            "telephone_number": "314-535-7855",
            "fax_number": "314-534-2803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4488 FOREST PARK AVE",
            "address_2": "STE 230",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631082283",
            "telephone_number": "314-535-7855",
            "fax_number": "314-534-2803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEYER",
        "first_name": "MARY",
        "middle_name": "SHAUGHNESSY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-26",
        "last_updated": "2025-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "2006006810",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200968204",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "affiliationName": "Washington University",
            "address_1": "4488 Forest Park Ave",
            "address_2": "STE 230",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631082283",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 Apr 18, 2025; 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.