Individual provider Active NPI

Richard Xavier Brennan, M.D.

  • Obstetrics & Gynecology Physician
  • Saint Louis, MO
National Provider Identifier
1316986540
Registry record updated Mar 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
MDR6H23 Issued in MO
Practice address
12700 Southfork Rd
Ste 230
Saint Louis, MO 63128-3201
Phone
(314) 849-3711
Fax
(314) 849-0235
NPI assigned
Jun 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X MDR6H23 MO Primary
Obstetrics & Gynecology Physician 207V00000X 336-069221 IL

Addresses

Primary practice location

12700 Southfork Rd
Ste 230
Saint Louis, MO 63128-3201

Mailing address

12700 Southfork Rd
Ste 230
Saint Louis, MO 63128-3201
Phone (314) 849-3711

Other identifiers 2

IdentifierTypeStateIssuer
156440092OtherMOMEDICARE PTAN #
206853004MedicaidMO

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
I20120607000720 MO Practitioner - Obstetrics/Gynecology 1658557913 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Saint Louis University School of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic East CommunitiesGroup PAC ID 7214827922, 573 clinicians

Practice addresses (Care Compare)

10004 Kennerly Rd
Suite 115a
Saint Louis, MO 63128-5106
Phone (314) 849-3711

12700 Southfork Rd
Saint Louis, MO 63128-3276

621 S New Ballas Rd
Suite 189a
Saint Louis, MO 63141-8255
Phone (314) 251-6335

621 S New Ballas Rd
Suite 4017B
Saint Louis, MO 63141-8269
Phone (314) 872-9192

Hospital & facility affiliations

  • Mercy Hospital South Hospital, Saint Louis, MO, CCN 260077
  • Mercy Hospital St Louis Hospital, Saint Louis, MO, CCN 260020
  • Mercy Hospital Jefferson Hospital, Crystal City, MO, CCN 260023

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
336-069221ILMDObstetrics & Gynecology Physician
MDR6H23MOMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic East Communities Obstetrics & Gynecology CurrentSince Jan 1, 2020 Accepting new patients
Brennan OB GYN Associate, P.C. Obstetrics & Gynecology CurrentSince Dec 31, 1991 Accepting new patients
Mercy Clinic East Communities CurrentSince Jan 1, 2020 Accepting new patients
Mercy Hospitals East Communities Past Accepting new patients
Mercy Hospital South Past Accepting new patients

Locations

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

10010 Kennerly Rd
Saint Louis, MO 63128
Phone (314) 525-1328

621 S New Ballas Rd
Ste 189A
Saint Louis, MO 63141
Phone (314) 251-6335

12700 Southfork Rd
Ste 230
Saint Louis, MO 63128
Phone (314) 525-4880

5425 Southfield Ctr
Saint Louis, MO 63123
Phone (314) 543-5258

13023 Tesson Ferry Rd
Ste 103
Saint Louis, MO 63128
Phone (314) 849-3711

621 S New Ballas Rd
Ste 4017B
Saint Louis, MO 63141
Phone (314) 872-9192

621 S New Ballas Rd
Ste 2009B
Saint Louis, MO 63141
Phone (314) 251-6062

9735 Landmark Parkway Dr
Ste 200
Saint Louis, MO 63127
Phone (314) 525-1887

Interoperability endpoints

  • Direct secure messaging: rbrennan99436@directc.mercy.net

Organizations & group practices 5

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489449600000",
    "number": "1316986540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12700 SOUTHFORK RD",
            "address_2": "STE 230",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631283201",
            "telephone_number": "314-849-3711",
            "fax_number": "314-849-0235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12700 SOUTHFORK RD",
            "address_2": "STE 230",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631283201",
            "telephone_number": "314-849-3711",
            "fax_number": "314-849-0235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRENNAN",
        "first_name": "RICHARD",
        "middle_name": "XAVIER",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-05",
        "last_updated": "2017-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MO",
            "license": "MDR6H23",
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "336-069221",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN #",
            "identifier": "156440092",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "206853004",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.