NPIMap

Organization Active NPI

SSM Medical Group Inc.

Doing business as SSM Health Medical Group

  • Durable Medical Equipment & Medical Supplies
  • Bridgeton, MO
National Provider Identifier
1285004598
Registry record updated Oct 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
SSM MEDICAL GROUP INC.
Doing business as
SSM Health Medical Group
Practice address
12255 Depaul Drive
Suite 120
Bridgeton, MO 63044
Phone
(314) 291-7900
NPI assigned
Sep 29, 2015
Last updated
Oct 19, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2018

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

Authorized official

Name
Bridget Eder
Title
Provider Enrollment Specialist
Phone
(636) 498-5944

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU Primary
Pain Medicine Physician 208VP0000X NU

Addresses

Primary practice location

12255 Depaul Drive
Suite 120
Bridgeton, MO 63044

Mailing address

3221 McKelvey Rd Ste 301
Bridgeton, MO 63044-2551
Phone (636) 498-5944

Other names 1

  • SSM Health Medical Group Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
26D2267276SSM Health Medical Group Executive Health North12255 Depaul Drive, Suite 100, Bridgeton, MO 63044Certificate of waiverAug 22, 2026

National Provider Directory

National Provider Directory
Tax ID family
Sterkel Hogan Spiro Gui18 organizations share this tax ID, including this one

Other organizations with this tax ID 17

Organizations that report the same tax identification number in the National Provider Directory.

View all 17

Locations

12255 De Paul Dr
Ste 550
Bridgeton, MO 63044
Phone (314) 291-9501

1011 Bowles Ave
Ste 205
Fenton, MO 63026
Phone (314) 966-8118

Practitioners & affiliated clinicians

Practitioners 15

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 15

NPI Registry JSON

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

{
    "created_epoch": "1443484800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1539907200000",
    "number": "1285004598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3221 MCKELVEY RD STE 301",
            "city": "BRIDGETON",
            "state": "MO",
            "postal_code": "630442551",
            "telephone_number": "636-498-5944",
            "fax_number": "314-209-8127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12255 DEPAUL DRIVE",
            "address_2": "SUITE 120",
            "city": "BRIDGETON",
            "state": "MO",
            "postal_code": "63044",
            "telephone_number": "314-291-7900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SSM MEDICAL GROUP INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-29",
        "last_updated": "2018-10-19",
        "status": "A",
        "authorized_official_last_name": "EDER",
        "authorized_official_first_name": "BRIDGET",
        "authorized_official_title_or_position": "PROVIDER ENROLLMENT SPECIALIST",
        "authorized_official_telephone_number": "636-498-5944"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SSM Health Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bridgeton, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.