Organization Active NPI

Physicians of St Anthonys Medical Center LC

Doing business as Mercy Clinic South Support Service Physicians

  • Pulmonary Disease Physician
  • Saint Louis, MO
National Provider Identifier
1316370059
Registry record updated Jan 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
Legal business name
PHYSICIANS OF ST ANTHONYS MEDICAL CENTER LC
Doing business as
Mercy Clinic South Support Service Physicians
Practice address
4850 Lemay Ferry Rd
Suite 210
Saint Louis, MO 63129-1576
Phone
(314) 892-6565
Fax
(314) 892-4828
NPI assigned
Aug 16, 2013
Last updated
Jan 4, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2019

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

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X Primary

Addresses

Primary practice location

4850 Lemay Ferry Rd
Suite 210
Saint Louis, MO 63129-1576

Mailing address

4850 Lemay Ferry Rd
Suite 210
Saint Louis, MO 63129-1576
Phone (314) 892-6565

Other names 1

  • Mercy Clinic South Support Service Physicians Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1376611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1546560000000",
    "number": "1316370059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4850 LEMAY FERRY RD",
            "address_2": "SUITE 210",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631291576",
            "telephone_number": "314-892-6565",
            "fax_number": "314-892-4828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4850 LEMAY FERRY RD",
            "address_2": "SUITE 210",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631291576",
            "telephone_number": "314-892-6565",
            "fax_number": "314-892-4828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIANS OF ST ANTHONYS MEDICAL CENTER LC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-16",
        "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": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mercy Clinic South Support Service Physicians",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 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.