Midwest Physicians Group

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

2006024364 Issued in MO

Legal business name

MIDWEST PHYSICIANS GROUP

Practice address

119 Church St Ste 135
Ferguson, MO 63135-2459

Phone

(314) 246-1690

Fax

(800) 331-9716

NPI assigned

Mar 29, 2018

Last updated

Mar 29, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

David Wills

Title

Owner

Phone

(314) 246-1690

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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.

• Cirese Webster, FNP-BC

  • Family Nurse Practitioner
  • Saint Louis, MO
  • NPI 1598100406
  NPD (past)

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

{
    "created_epoch": "1522281600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522281600000",
    "number": "1366947400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 69141",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631690141",
            "telephone_number": "314-246-1690",
            "fax_number": "800-331-9716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 CHURCH ST STE 135",
            "city": "FERGUSON",
            "state": "MO",
            "postal_code": "631352459",
            "telephone_number": "314-246-1690",
            "fax_number": "800-331-9716"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "440 N 4th St",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631022654",
            "country_code": "US",
            "telephone_number": "314-246-1690",
            "fax_number": "800-331-9716",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MIDWEST PHYSICIANS GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-29",
        "last_updated": "2018-03-29",
        "status": "A",
        "authorized_official_last_name": "WILLS",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "314-246-1690"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2006024364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Made 2 Care Home Health LLC
• Patricia A. McDade Jenkins, MSN, RN,FNP-BC
• Olivia McGaugh, MSW, LCSW
• Merit Home Health Care, Inc.
• Merit Home Health Care, Inc.
• Emma Jean Miles
• Missouri Community Doula Council
• Missouri CVS Pharmacy, L.L.C. (CVS Pharmacy #18061)
• Mobile Eye Care Technologies Inc
• Deja Myers

• Internal Medicine Physician in Ferguson, MO
• Providers in Ferguson, MO by specialty
• Internal Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2018; 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.