NPIMap

Organization Active NPI

SSM Health Care St Louis

Doing business as SSM Health St Clare Fenton

  • Emergency Medicine Physician
  • Fenton, MO
National Provider Identifier
1275586174
Registry record updated Jun 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
SSM HEALTH CARE ST LOUIS
Doing business as
SSM Health St Clare Fenton
SSM Health St Clare Hospital
SSM Health St. Clare Hospital Physician Billing
Practice address
1015 Bowles Avenue
Fenton, MO 63026
Phone
(636) 496-2502
NPI assigned
May 19, 2006
Last updated
Jun 2, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
SSM HEALTH CARE ST. LOUISAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 2, 2026

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

Authorized official

Name
Jeremy Fotheringham
Title
Regional President
Phone
(636) 496-2000

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X NU Primary
Cardiovascular Disease Physician 207RC0000X NU
Vascular Surgery Physician 2086S0129X NU

Addresses

Primary practice location

1015 Bowles Avenue
Fenton, MO 63026

Mailing address

12800 Corporate Hill Dr
Saint Louis, MO 63131-1833
Phone (557) 203-1486

Other practice location 1

1011 Bowles Ave
Fenton, MO 63026-2395
Phone (557) 203-1486

Other practice location 2

1296 Jeffco Blvd Ste B
Arnold, MO 63010-2138
Phone (636) 321-8604

Other identifiers 1

IdentifierTypeStateIssuer
545011009MedicaidMO

Other names 3

  • SSM Health St Clare Fenton Doing business as
  • SSM Health St Clare Hospital Doing business as
  • SSM Health St. Clare Hospital Physician Billing Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, IL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031118000393 MO Part B Supplier - Clinic/Group Practice 7810800737 Receives reassigned benefits from 776 practitioners
5 other NPIs on this enrollment
Practice locations: Maryland Heights, MO; O Fallon, MO; Saint Charles, MO; Florissant, MO; Saint Louis, MO; Wentzville, MO; Bridgeton, MO; Arnold, MO…
O20251024002672 IL Part B Supplier - Clinic/Group Practice 7810800737 Receives reassigned benefits from 1 practitioner
Practice locations: Columbia, IL

Other NPIs with the same Medicare PAC ID 13

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 13

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
William D Huffstutler M

Locations (25 of 56)

7344 Solutions Ctr
Chicago, IL 60677
Phone (314) 989-6189

1296 Jeffco Blvd
Ste B
Arnold, MO 63010
Phone (636) 321-8600

12255 De Paul Dr
Ste 370
Bridgeton, MO 63044
Phone (314) 209-5222

12255 De Paul Dr
Ste 400
Bridgeton, MO 63044
Phone (314) 218-2300

12266 De Paul Dr
Ste 10
Bridgeton, MO 63044
Phone (314) 291-7500

12266 De Paul Dr
Ste 110
Bridgeton, MO 63044

12266 De Paul Dr
Ste 315
Bridgeton, MO 63044
Phone (314) 739-5858

12277 De Paul Dr
Ste 301
Bridgeton, MO 63044
Phone (314) 344-6495

12277 De Paul Dr
Ste 310
Bridgeton, MO 63044
Phone (314) 209-5142

12303 De Paul Dr
Ste 101
Bridgeton, MO 63044
Phone (314) 344-6090

12349 De Paul Dr
Ste 110
Bridgeton, MO 63044
Phone (314) 209-7700

3440 De Paul Ln
Ste 100
Bridgeton, MO 63044
Phone (314) 739-0924

3440 De Paul Ln
Ste 104
Bridgeton, MO 63044
Phone (314) 209-5225

3440 De Paul Ln
Ste 207
Bridgeton, MO 63044
Phone (314) 344-3403

1011 Bowles Ave
Fenton, MO 63026
Phone (314) 843-5800

1011 Bowles Ave
Ste 225
Fenton, MO 63026

1011 Bowles Ave
Ste 400405
Fenton, MO 63026

1011 Bowles Ave
Ste 425
Fenton, MO 63026
Phone (636) 326-2600

1011 Bowles Ave
Ste G20
Fenton, MO 63026
Phone (636) 496-5439

1011 Bowles Ave
Ste G50
Fenton, MO 63026
Phone (636) 496-4600

1015 Bowles Ave
Fenton, MO 63026
Phone (636) 496-2000

1015 Bowles Ave
Ste 300
Fenton, MO 63026
Phone (636) 496-2820

1345 Smizer Mill Rd
Ste 1700
Fenton, MO 63026
Phone (636) 496-4030

1201 Garden Plaza Dr
Florissant, MO 63033
Phone (314) 831-3752

2 Harbor Bend Ct
Ste 100
Lake Saint Louis, MO 63367
Phone (636) 695-2030

Ownership & related parties

All facility ownership & control disclosures 11

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
SSM Health St. Clare Hospital - FentonFenton, MO, CCN 260081 Hospital 5% Or Greater Direct Ownership Interest (100%) Sep 1, 2015
SSM Health Rehabilitation HospitalRichmond Heights, MO, CCN 263031 Hospital 5% Or Greater Direct Ownership Interest (49%) May 1, 2009
SSM Health Saint Louis University HospitalSaint Louis, MO, CCN 260105 Hospital 5% Or Greater Direct Ownership Interest (100%) Sep 1, 2015
SSM Health Saint Louis University HospitalSaint Louis, MO, CCN 26S105 Hospital 5% Or Greater Direct Ownership Interest (100%) Sep 1, 2015
SSM Health St Joseph Hospital - Lake Saint LouisLake Saint Louis, MO, CCN 260200 Hospital 5% Or Greater Direct Ownership Interest (100%) Sep 17, 2014
SSM Health St Joseph Hospital - St CharlesSaint Charles, MO, CCN 260005 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control		 Sep 11, 1984
Oct 12, 2015
SSM Health St. Mary's Hospital - St. LouisSaint Louis, MO, CCN 26S091 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 13, 2014
SSM Health St. Mary's Hospital - St LouisSaint Louis, MO, CCN 260091 Hospital 5% Or Greater Direct Ownership Interest (100%) Sep 11, 1984
SSM Health Depaul Hospital St LouisBridgeton, MO, CCN 26S104 Hospital 5% Or Greater Direct Ownership Interest (100%) Dec 16, 2013
SSM Health Depaul Hospital - St LouisBridgeton, MO, CCN 260104 Hospital 5% Or Greater Direct Ownership Interest (100%) Oct 10, 2014
SSM Health Depaul Hospital - Anna HouseBridgeton, MO, CCN 265842 Skilled nursing facility 5% Or Greater Indirect Ownership Interest (100%) Sep 1, 2015

Owned or controlled facilities with NPI records 12

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

  • SSM Health Care St. Louis

    dba SSM Health DePaul Hospital - St. Louis

    • Psychiatric Hospital Unit
    • Bridgeton, MO
    • NPI 1053481861

    5% Or Greater Direct Ownership Interest

    CMS ownership
  • SSM Health Care St. Louis

    dba SSM Health Cardinal Glennon Children's Hospital

    • General Acute Care Hospital
    • Saint Louis, MO
    • NPI 1336387836

    5% Or Greater Direct Ownership Interest

    CMS ownership
  • SSM Health Care St. Louis

    dba SSM Health DePaul Hospital - Anna House

    • Skilled Nursing Facility
    • Bridgeton, MO
    • NPI 1346237112

    5% Or Greater Indirect Ownership Interest

    CMS ownership
  • SSM Health Care St. Louis

    dba SSM Health St. Joseph Hospital - St. Charles

    • General Acute Care Hospital
    • Saint Charles, MO
    • NPI 1467521146

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • SSM Health Care St. Louis

    dba SSM Health DePaul Hospital - St. Louis

    • General Acute Care Hospital
    • Bridgeton, MO
    • NPI 1598835308

    5% Or Greater Direct Ownership Interest

    CMS ownership
  • SSM Health Care St. Louis

    dba SSM Health St. Mary's Hospital - St. Louis

    • Psychiatric Hospital Unit
    • Saint Louis, MO
    • NPI 1780763284

    5% Or Greater Direct Ownership Interest

    CMS ownership
  • SSM Health Care St. Louis

    dba SSM Health St. Clare Hospital - Fenton

    • General Acute Care Hospital
    • Fenton, MO
    • NPI 1851496152

    5% Or Greater Direct Ownership Interest

    CMS ownership
  • SSM Health Care St. Louis

    dba SSM Health St Joseph Hospital - Lake Saint Louis

    • General Acute Care Hospital
    • Lake St Louis, MO
    • NPI 1871665380

    5% Or Greater Direct Ownership Interest

    CMS ownership
  • SSM Health Care St. Louis

    dba SSM Health St. Mary's Hospital - St. Louis

    • General Acute Care Hospital
    • Saint Louis, MO
    • NPI 1962572396

    5% Or Greater Direct Ownership Interest

    CMS ownership
  • SSM Select Rehab St Louis LLC
    • Rehabilitation Hospital
    • Richmond Heights, MO
    • NPI 1659511988

    5% Or Greater Direct Ownership Interest

    CMS ownership
  • SSM-Sluh Inc

    dba SSM Health Saint Louis University Hospital

    • Psychiatric Hospital Unit
    • Saint Louis, MO
    • NPI 1528443702

    5% Or Greater Direct Ownership Interest

    CMS ownership
  • SSM-Sluh Inc

    dba SSM Health Saint Louis University Hospital

    • General Acute Care Hospital
    • Saint Louis, MO
    • NPI 1942685920

    5% Or Greater Direct Ownership Interest

    CMS ownership

Practitioners & affiliated clinicians

Practitioners 837

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 837

NPI Registry JSON

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1780358400000",
    "number": "1275586174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12800 CORPORATE HILL DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631311833",
            "telephone_number": "557-203-1486",
            "fax_number": "314-344-7239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 BOWLES AVENUE",
            "city": "FENTON",
            "state": "MO",
            "postal_code": "63026",
            "telephone_number": "636-496-2502"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1011 Bowles Ave",
            "address_purpose": "LOCATION",
            "city": "Fenton",
            "state": "MO",
            "postal_code": "630262395",
            "country_code": "US",
            "telephone_number": "557-203-1486",
            "fax_number": "314-344-7239",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1296 Jeffco Blvd Ste B",
            "address_purpose": "LOCATION",
            "city": "Arnold",
            "state": "MO",
            "postal_code": "630102138",
            "country_code": "US",
            "telephone_number": "636-321-8604",
            "fax_number": "314-344-7281",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SSM HEALTH CARE ST LOUIS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SSM HEALTH CARE ST. LOUIS",
        "enumeration_date": "2006-05-19",
        "last_updated": "2026-06-02",
        "certification_date": "2026-06-02",
        "status": "A",
        "authorized_official_last_name": "FOTHERINGHAM",
        "authorized_official_first_name": "JEREMY",
        "authorized_official_title_or_position": "REGIONAL PRESIDENT",
        "authorized_official_telephone_number": "636-496-2000"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "545011009",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SSM Health St Clare Fenton",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "SSM Health St Clare Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "SSM Health St. Clare Hospital Physician Billing",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "SSM Health St. Clare Hospital Physician Billing",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fenton, MO

Sources for this page

Verify at the official NPI Registry.