Active NPI
Celia Bangert, MD
- Pediatrics Physician
- Saint Louis, MO
National Provider Identifier
1376160499
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 2020019594
- Practice address
- 30 Ronnies PLZ
Saint Louis, MO 63126-3552 - Phone
- (314) 748-5800
- NPI assigned
- Jul 6, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 2020019594 | MO | Primary |
Addresses
Primary practice location
30 Ronnies PLZ
Saint Louis, MO 63126-3552
Mailing address
30 Ronnies PLZ
Saint Louis, MO 63126-3552
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2020019594 | MO | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| SSM Health Care St. Louis | Pediatrics | Past | Accepting new patients |
Interoperability endpoints
- cbangert452591@direct-ehr-ssmhc.com
Organizations & group practices 1
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": "1593993600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1684368000000",
"number": "1376160499",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30 RONNIES PLZ",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631263552"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30 RONNIES PLZ",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631263552",
"telephone_number": "314-748-5800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BANGERT",
"first_name": "CELIA",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-07-06",
"last_updated": "2023-05-18",
"certification_date": "2023-05-18",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MO",
"license": "2020019594",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
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 May 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.