NPIMap

Organization Active NPI

Family Medicine - SLMG South, LLC

  • Family Medicine Physician
  • Imperial, MO
National Provider Identifier
1164077822
Registry record updated Mar 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
FAMILY MEDICINE - SLMG SOUTH, LLC
Practice address
1501 Professional Dr
Imperial, MO 63052-3809
Phone
(636) 464-4000
Fax
(636) 529-0699
NPI assigned
Aug 8, 2019
Last updated
Mar 5, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
ST. LUKES MEDICAL GROUPAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 5, 2026

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

Authorized official

Name
Darren R. Haskell, M.D.NPI 1689636813
Title
Chief Medical Officer
Phone
(314) 205-6444

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
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

1501 Professional Dr
Imperial, MO 63052-3809

Mailing address

121 Saint Lukes Center Dr
Chesterfield, MO 63017-3518
Phone (636) 685-7804

Other practice location 1

103 Hilltop Village Shopping Center Dr.
Eureka, MO 63025
Phone (636) 587-6350

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190925003479 MO Part B Supplier - Clinic/Group Practice 3971833443 Receives reassigned benefits from 25 practitioners
Practice locations: Arnold, MO; Eureka, MO; Imperial, MO

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
26D0437769Family Medicine-SLMG South, LLC103 Hilltop Village Center Dr, Eureka, MO 63025Certificate of waiverSep 28, 2027

National Provider Directory

National Provider Directory
Part of
St Lukes Medical Group

Locations

874 Arnold Commons Dr
Arnold, MO 63010
Phone (314) 864-8596

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 26

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 26

NPI Registry JSON

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

{
    "created_epoch": "1565222400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1772668800000",
    "number": "1164077822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 SAINT LUKES CENTER DR",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630173518",
            "telephone_number": "636-685-7804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 PROFESSIONAL DR",
            "city": "IMPERIAL",
            "state": "MO",
            "postal_code": "630523809",
            "telephone_number": "636-464-4000",
            "fax_number": "636-529-0699"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "103 Hilltop Village Shopping Center Dr.",
            "address_purpose": "LOCATION",
            "city": "Eureka",
            "state": "MO",
            "postal_code": "63025",
            "country_code": "US",
            "telephone_number": "636-587-6350",
            "fax_number": "636-529-0699",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "FAMILY MEDICINE - SLMG SOUTH, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ST. LUKES MEDICAL GROUP",
        "enumeration_date": "2019-08-08",
        "last_updated": "2026-03-05",
        "certification_date": "2026-03-05",
        "status": "A",
        "authorized_official_last_name": "HASKELL",
        "authorized_official_first_name": "DARREN",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "CHIEF MEDICAL OFFICER",
        "authorized_official_telephone_number": "314-205-6444",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Imperial, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.