Individual provider Active NPI

John A Myers, MD

  • Pediatrics Physician
  • O Fallon, MO
National Provider Identifier
1275508590
Registry record updated Apr 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
112791 Issued in MO
Practice address
20 Progress Point Pkwy
Ste 220
O Fallon, MO 63368-2206
Phone
(636) 344-3333
Fax
(636) 344-3334
NPI assigned
Feb 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 112791 MO Primary

Addresses

Primary practice location

20 Progress Point Pkwy
Ste 220
O Fallon, MO 63368-2206

Mailing address

PO Box 7412027
Chicago, IL 60674-2027
Phone (636) 344-3333

Other identifiers 1

IdentifierTypeStateIssuer
200026271MedicaidMO

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Washington University

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
I20150710002584 MO Practitioner - Pediatric Medicine 6507178035 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Wuca-O'Fallon Pediatrics, LLC Pediatrics CurrentSince May 3, 2015 Accepting new patients
Wuca-Westside Pediatrics LLC Pediatrics PastSince May 3, 2015 Accepting new patients

Locations

20 Progress Point Pkwy
Ste 220
O Fallon, MO 63368
Phone (636) 344-3333

20 Progress Point Pkwy
Ste 22
O Fallon, MO 63368

Interoperability endpoints

  • Direct secure messaging: jmyers153996@direct.carenet.org

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1140480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744934400000",
    "number": "1275508590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7412027",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606742027",
            "telephone_number": "636-344-3333",
            "fax_number": "636-344-3334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 PROGRESS POINT PKWY",
            "address_2": "STE 220",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633682206",
            "telephone_number": "636-344-3333",
            "fax_number": "636-344-3334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYERS",
        "first_name": "JOHN",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-21",
        "last_updated": "2025-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "112791",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200026271",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "affiliationName": "Washington University",
            "address_1": "20 Progress Point Pkwy",
            "address_2": "STE 220",
            "city": "O Fallon",
            "state": "MO",
            "country_code": "US",
            "postal_code": "633682206",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in O Fallon, MO

Sources for this page

Verify at the official NPI Registry.