Individual provider Active NPI

Emma Libby, MD

  • Urology Physician
  • Saint Louis, MO
National Provider Identifier
1194386375
Registry record updated Aug 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
2024021834 Issued in MO
Practice address
12700 Southfork Rd Ste 260
Saint Louis, MO 63128-3288
Phone
(314) 543-5270
NPI assigned
Jun 27, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 2024021834 MO Primary

Addresses

Primary practice location

12700 Southfork Rd Ste 260
Saint Louis, MO 63128-3288

Mailing address

12700 Southfork Rd Ste 260
Saint Louis, MO 63128-3288
Phone (314) 543-5270

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240916002015 MO Practitioner - Urology 3870828031 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
University of Missouri, Columbia School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic Urology LLCGroup PAC ID 5395768253, 26 clinicians

Practice addresses (Care Compare)

12700 Southfork Rd
Suite 260
Saint Louis, MO 63128-3288
Phone (314) 251-8850

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2024021834MOMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Urology LLC Urology CurrentSince Aug 26, 2024 Accepting new patients

Locations

12700 Southfork Rd
Ste 260
Saint Louis, MO 63128
Phone (314) 251-8850

7345 Watson Rd
Ste 102
Saint Louis, MO 63119
Phone (314) 543-5270

607 S New Ballas Rd
Ste 3100
Saint Louis, MO 63141
Phone (314) 251-4260

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1561593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723766400000",
    "number": "1194386375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12700 SOUTHFORK RD STE 260",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631283288",
            "telephone_number": "314-543-5270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12700 SOUTHFORK RD STE 260",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631283288",
            "telephone_number": "314-543-5270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIBBY",
        "first_name": "EMMA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-27",
        "last_updated": "2024-08-16",
        "certification_date": "2024-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MO",
            "license": "2024021834",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.