St. Anthony's Physician Organization

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

ST. ANTHONY'S PHYSICIAN ORGANIZATION

Doing business as

Mercy Clinic South Physicians

Practice address

215 Thresher Dr
Eureka, MO 63025-1923

Phone

(314) 543-5968

Fax

(314) 543-5918

NPI assigned

Apr 23, 2015

Last updated

Jan 4, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Cheryl Matejka

Title

Cfo East Communities & Sfo

Phone

(314) 251-1958

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Mercy Clinic South Physicians Doing business as

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

{
    "created_epoch": "1429747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1546560000000",
    "number": "1225425630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9735 LANDMARK PARKWAY DR",
            "address_2": "STE 200",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631271646",
            "telephone_number": "314-543-6985",
            "fax_number": "314-543-6836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 THRESHER DR",
            "city": "EUREKA",
            "state": "MO",
            "postal_code": "630251923",
            "telephone_number": "314-543-5968",
            "fax_number": "314-543-5918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. ANTHONY'S PHYSICIAN ORGANIZATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-23",
        "last_updated": "2019-01-04",
        "status": "A",
        "authorized_official_last_name": "MATEJKA",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_title_or_position": "CFO EAST COMMUNITIES & SFO",
        "authorized_official_telephone_number": "314-251-1958",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PTAN #",
            "identifier": "000015644",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mercy Clinic South Physicians",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Family Medicine Physician in Eureka, MO
• Providers in Eureka, MO by specialty
• Family Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.