Active NPI
Nancy Bauer, MD
- Pediatrics Physician
- Saint Louis, MO
National Provider Identifier
1154431336
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 2009003427
- Practice address
- 401 Holly Hills Ave
Saint Louis, MO 63111-2410 - Phone
- (314) 353-5190
- Fax
- (314) 353-7631
- NPI assigned
- Aug 30, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neonatal-Perinatal Medicine Physician | 2080N0001X | 036-101522 | IL | |
| Pediatrics Physician | 208000000X | 2009003427 | MO | Primary |
Addresses
Primary practice location
401 Holly Hills Ave
Saint Louis, MO 63111-2410
Mailing address
401 Holly Hills Ave
Saint Louis, MO 63111-2410
Phone (314) 353-5190
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
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050412000000 | MO | Practitioner - Pediatric Medicine | 6901843978 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2009003427 | MO | MD | Pediatrics Physician |
| 036-101522 | IL | MD | Neonatal-Perinatal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Care Health Centers | Current | Accepting new patients | |
| Family Care Health Centers | Current | Accepting new patients | |
| SSM Health Care St. Louis | Pediatrics | Past | Accepting new patients |
| Compass Health, Inc | Past | Accepting new patients | |
| SSM St. Joseph Endoscopy Center, LLC | Past | Accepting new patients | |
| SSM Health Care St. Louis | Past | Accepting new patients |
Locations
4352 Manchester Ave
Saint Louis, MO 63110
Phone (314) 371-0336
401 Holly Hills Ave
Saint Louis, MO 63111
Phone (314) 353-5190
Organizations & group practices 6
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.
-
- Federally Qualified Health Center (FQHC)
- Saint Louis, MO
- NPI 1508867508
MO
-
- Federally Qualified Health Center (FQHC)
- Saint Louis, MO
- NPI 1023285624
-
- Federally Qualified Health Center (FQHC)
- Saint Peters, MO
- NPI 1922719871
-
- General Acute Care Hospital
- Lake St Louis, MO
- NPI 1871665380
-
- Clinic/Center
- Saint Peters, MO
- NPI 1871536037
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1770768000000",
"number": "1154431336",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "401 HOLLY HILLS AVE",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631112410",
"telephone_number": "314-353-5190",
"fax_number": "314-353-7631"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "401 HOLLY HILLS AVE",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631112410",
"telephone_number": "314-353-5190",
"fax_number": "314-353-7631"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAUER",
"first_name": "NANCY",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-30",
"last_updated": "2026-02-11",
"certification_date": "2026-02-11",
"status": "A"
},
"taxonomies": [
{
"code": "2080N0001X",
"taxonomy_group": "",
"desc": "Pediatrics, Neonatal-Perinatal Medicine",
"state": "IL",
"license": "036-101522",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MO",
"license": "2009003427",
"primary": true
}
],
"identifiers": [],
"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 Feb 11, 2026; 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.