NPIMap

Organization Active NPI

St. Anthony's Physician Organization

Doing business as Mercy Clinic South Physicians

  • Family Medicine Physician
  • Saint Louis, MO
National Provider Identifier
1336469261
Registry record updated Jan 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ST. ANTHONY'S PHYSICIAN ORGANIZATION
Doing business as
Mercy Clinic South Physicians
Practice address
5425 Southfield Ctr
Saint Louis, MO 63123-5984
Phone
(314) 543-5258
Fax
(314) 543-5262
NPI assigned
Jun 2, 2010
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
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

5425 Southfield Ctr
Saint Louis, MO 63123-5984

Mailing address

5425 Southfield Ctr
Saint Louis, MO 63123-5984
Phone (314) 543-5258

Other identifiers 1

IdentifierTypeStateIssuer
000015649OtherMOMEDICARE PTAN

Other names 1

  • Mercy Clinic South Physicians Doing business as

National Provider Directory

National Provider Directory

Locations

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

NPI Registry JSON

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

{
    "created_epoch": "1275436800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1546560000000",
    "number": "1336469261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5425 SOUTHFIELD CTR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631235984",
            "telephone_number": "314-543-5258",
            "fax_number": "314-543-5262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5425 SOUTHFIELD CTR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631235984",
            "telephone_number": "314-543-5258",
            "fax_number": "314-543-5262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. ANTHONY'S PHYSICIAN ORGANIZATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-02",
        "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": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "000015649",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mercy Clinic South 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.