Individual provider Active NPI

Stephanie Erica Liebmann, M.D.

  • Family Medicine Physician
  • Saint Louis, MO
National Provider Identifier
1366649253
Registry record updated Jul 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2007018098 Issued in MO
Practice address
1315 Aubert Ave
Saint Louis, MO 63113-1918
Phone
(314) 449-9726
NPI assigned
Jul 2, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2007018098 MO Primary

Addresses

Primary practice location

1315 Aubert Ave
Saint Louis, MO 63113-1918

Mailing address

102 Woodmont Blvd Ste 600
Nashville, TN 37205-5250
Phone (629) 224-1616

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
I20100921001352 MO Practitioner - Family Practice 2860518362 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Saint Louis University School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Archwell Health Professional Services of Kansas PAGroup PAC ID 4688072358, 25 clinicians

Practice addresses (Care Compare)

1315 Aubert Ave
Saint Louis, MO 63113-1918
Phone (314) 449-9726

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2007018098MOMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Archwell Health Professional Services of Kansas, P.a. CurrentSince Jul 1, 2023 Accepting new patients

Locations

199 N Florissant Rd
Ferguson, MO 63135
Phone (314) 449-9640

11605 E 23rd St S
Independence, MO 64050
Phone (816) 579-6891

1315 Aubert Ave
Saint Louis, MO 63113
Phone (314) 449-9726

102 Woodmont Blvd
Ste 600
Nashville, TN 37205

Interoperability endpoints

  • Direct secure messaging: sliebmann1977@directc.mercy.net

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1183334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689033600000",
    "number": "1366649253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 WOODMONT BLVD STE 600",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372055250",
            "telephone_number": "629-224-1616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1315 AUBERT AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631131918",
            "telephone_number": "314-449-9726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIEBMANN",
        "first_name": "STEPHANIE",
        "middle_name": "ERICA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-02",
        "last_updated": "2023-07-11",
        "certification_date": "2023-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2007018098",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.