NPIMap

Organization Active NPI

Missouri Baptist Physician Services LLC

  • Medical Specialty Clinic/Center
  • Saint Louis, MO
National Provider Identifier
1245310291
Registry record updated Jan 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
Legal business name
MISSOURI BAPTIST PHYSICIAN SERVICES LLC
Practice address
3009 N Ballas Rd
266C
Saint Louis, MO 63131-2322
Phone
(314) 996-5287
Fax
(314) 996-5005
NPI assigned
Oct 16, 2006
Last updated
Jan 20, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2023

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

Authorized official

Name
Ann Abad
Title
President
Phone
(314) 996-8401

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X Primary

Addresses

Primary practice location

3009 N Ballas Rd
266C
Saint Louis, MO 63131-2322

Mailing address

3015 N Ballas Rd
Physician Services
Saint Louis, MO 63131-2329
Phone (314) 996-5119

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Missouri Baptist Medical Center

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050613000191 MO Part B Supplier - Clinic/Group Practice 0446294342 Receives reassigned benefits from 31 practitioners
Practice locations: Farmington, MO; Saint Louis, MO; Ste Genevieve, MO; Sullivan, MO

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

3009 N Ballas Rd
Ste 251C
Saint Louis, MO 63131
Phone (314) 569-2680

3009 N Ballas Rd
Ste 323A
Saint Louis, MO 63131
Phone (314) 942-2213

3023 N Ballas Rd
Ste 150D
Saint Louis, MO 63131
Phone (314) 996-5287

800 Ste Genevieve Dr
Ste Genevieve, MO 63670
Phone (573) 883-2571

Practitioners & affiliated clinicians

Practitioners 51

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 51

NPI Registry JSON

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674172800000",
    "number": "1245310291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3015 N BALLAS RD",
            "address_2": "PHYSICIAN SERVICES",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631312329",
            "telephone_number": "314-996-5119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3009 N BALLAS RD",
            "address_2": "266C",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631312322",
            "telephone_number": "314-996-5287",
            "fax_number": "314-996-5005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSOURI BAPTIST PHYSICIAN SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-16",
        "last_updated": "2023-01-20",
        "certification_date": "2023-01-20",
        "status": "A",
        "authorized_official_last_name": "ABAD",
        "authorized_official_first_name": "ANN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "314-996-8401"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "affiliationName": "Missouri Baptist Medical Center",
            "address_1": "3015 N Ballas Rd",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631312329",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 Jan 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.