Active NPI
Terry J Weis, DO
- Orthopaedic Surgery Physician
- Bridgeton, MO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- R5197
- Practice address
- 12266 Depaul Dr
110
Bridgeton, MO 63044-2514 - Phone
- (314) 291-7900
- Fax
- (314) 291-7914
- NPI assigned
- Jul 14, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | R5197 | MO | Primary |
Addresses
Primary practice location
12266 Depaul Dr
110
Bridgeton, MO 63044-2514
Mailing address
16582 Baxter Forest Ridge Dr
Chesterfield, MO 63005-4662
Phone (314) 291-7900
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 240975904 | Medicaid | MO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| SSM Medical Group, Inc. | Current | Accepting new patients | |
| SSM Depaul Medical Group, Inc. | Past | Accepting new patients | |
| Northland Orthopedic Group | Past | Accepting new patients |
Locations
12349 De Paul Dr
Ste 100
Bridgeton, MO 63044
Phone (314) 291-3399
12277 De Paul Dr
Ste 100
Bridgeton, MO 63044
Phone (314) 209-4560
14021 New Halls Ferry Rd
Florissant, MO 63033
Phone (314) 839-0910
1035 Bellevue Ave
Ste 500
Saint Louis, MO 63117
Phone (314) 647-1115
Organizations & group practices 3
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.
-
- Multi-Specialty Clinic/Center
- Fenton, MO
- NPI 1700966207
-
- Specialist
- Florissant, MO
- NPI 1891717351
-
- Family Medicine Physician
- Florissant, MO
- NPI 1952312951
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152835200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1299110400000",
"number": "1154347995",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16582 BAXTER FOREST RIDGE DR",
"city": "CHESTERFIELD",
"state": "MO",
"postal_code": "630054662",
"telephone_number": "314-291-7900"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12266 DEPAUL DR",
"address_2": "110",
"city": "BRIDGETON",
"state": "MO",
"postal_code": "630442514",
"telephone_number": "314-291-7900",
"fax_number": "314-291-7914"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEIS",
"first_name": "TERRY",
"middle_name": "J",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-14",
"last_updated": "2011-03-03",
"status": "A"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "MO",
"license": "R5197",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "240975904",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Bridgeton, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2011; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.