Individual provider Active NPI

Stephanie M Meyer, MD

  • Family Medicine Physician
  • Pacific, MO
National Provider Identifier
1215148341
Registry record updated Sep 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2009001451 Issued in MO
Practice address
307 Noonan Dr
Pacific, MO 63069-1136
Phone
(636) 271-9100
Fax
(636) 257-6016
NPI assigned
May 24, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2009001451 MO Primary

Addresses

Primary practice location

307 Noonan Dr
Pacific, MO 63069-1136

Mailing address

307 Noonan Dr
Pacific, MO 63069-1136
Phone (636) 271-9100

Other identifiers 2

IdentifierTypeStateIssuer
1215148341MedicaidMO
P00779628OtherMORAILROAD MEDICARE

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
I20090813000369 MO Practitioner - Family Practice 3779637590 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Missouri, Kansas City, School of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic East CommunitiesGroup PAC ID 7214827922, shared by 6 NPIs, 573 clinicians

Practice addresses (Care Compare)

12200 Weber Hill Rd
Suite 100
Saint Louis, MO 63127-1569
Phone (314) 698-2500

307 Noonan Dr
Pacific, MO 63069-1136
Phone (636) 271-9100

Hospital & facility affiliations

  • Mercy Home Health Home health agency, Saint Louis, MO, CCN 267565
  • Mercy Hospice Hospice, Saint Louis, MO, CCN 261510
  • Mercy Hospital Washington Hospital, Washington, MO, CCN 260052
  • Mercy Hospital St Louis Hospital, Saint Louis, MO, CCN 260020

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2009001451MOMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Hospitals East Communities Family Medicine CurrentSince Feb 4, 2011 Accepting new patients
Mercy Clinic East Communities Family Medicine CurrentSince Jul 6, 2009 Accepting new patients
Mercy Hospitals East Communities Family Medicine CurrentSince Feb 4, 2011 Accepting new patients
Mercy Clinic East Communities Family Medicine Current Accepting new patients
Mercy Clinic East Communities Family Medicine CurrentSince Jul 6, 2009 Accepting new patients
Ozarks Medical Center Family Medicine Past Accepting new patients

Locations

1203 Smizer Mill Rd
Ste 105
Fenton, MO 63026
Phone (636) 717-1350

307 Noonan Dr
Pacific, MO 63069
Phone (636) 271-9100

621 S New Ballas Rd
Ste 189A
Saint Louis, MO 63141
Phone (314) 251-6335

12200 Weber Hill Rd
Ste 100
Saint Louis, MO 63127
Phone (314) 698-2400

621 S New Ballas Rd
Ste 4017B
Saint Louis, MO 63141
Phone (314) 872-9192

901 E 5th St
Washington, MO 63090
Phone (636) 239-8000

851 E 5th St
Ste 328
Washington, MO 63090
Phone (636) 239-1101

Interoperability endpoints

  • Direct secure messaging: smeyer1974@directc.mercy.net

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.

Hospital & facility affiliations 5

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": "1179964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410134400000",
    "number": "1215148341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 NOONAN DR",
            "city": "PACIFIC",
            "state": "MO",
            "postal_code": "630691136",
            "telephone_number": "636-271-9100",
            "fax_number": "636-257-6016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 NOONAN DR",
            "city": "PACIFIC",
            "state": "MO",
            "postal_code": "630691136",
            "telephone_number": "636-271-9100",
            "fax_number": "636-257-6016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEYER",
        "first_name": "STEPHANIE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-24",
        "last_updated": "2014-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2009001451",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1215148341",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00779628",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pacific, MO

Sources for this page

Verify at the official NPI Registry.