Individual provider Active NPI

Mary Beth Chitwood, MD

  • Family Medicine Physician
  • Arnold, MO
National Provider Identifier
1376504621
Registry record updated Aug 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2002014087 Issued in MO
Practice address
3619 Richardson Square Dr
Suite 170
Arnold, MO 63010
Phone
(636) 717-6776
Fax
(314) 525-4055
NPI assigned
Mar 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2013

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 2002014087 MO Primary

Addresses

Primary practice location

3619 Richardson Square Dr
Suite 170
Arnold, MO 63010

Mailing address

3619 Richardson Square Dr
Suite 170
Arnold, MO 63010
Phone (636) 717-6776

Other names 1

  • Mary Beth Weick Former name

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
I20040908000215 MO Practitioner - Family Practice 8325014749 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Missouri, Columbia School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Clinic East CommunitiesGroup PAC ID 7214827922, 573 clinicians

Practice addresses (Care Compare)

3619 Richardson Square Dr
Suite 170
Arnold, MO 63010-6014
Phone (636) 717-6776

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2002014087MOMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic East Communities Family Medicine CurrentSince Jan 1, 2020 Accepting new patients
Mercy Clinic East Communities Family Medicine CurrentSince Jan 1, 2020 Accepting new patients
Ozarks Medical Center Family Medicine Past Accepting new patients

Locations

3619 Richardson Square Dr
Ste 170
Arnold, MO 63010
Phone (636) 717-6776

3619 Richardson Square Dr
Arnold, MO 63010
Phone (636) 461-1414

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

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

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

14377 Woodlake Dr
Twn and Cntry, MO 63017
Phone (314) 434-1111

Interoperability endpoints

  • Direct secure messaging: mchitwood1204@directc.mercy.net

Organizations & group practices 3

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": "1143504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377561600000",
    "number": "1376504621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3619 RICHARDSON SQUARE DR",
            "address_2": "SUITE 170",
            "city": "ARNOLD",
            "state": "MO",
            "postal_code": "63010",
            "telephone_number": "636-717-6776",
            "fax_number": "314-525-4055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3619 RICHARDSON SQUARE DR",
            "address_2": "SUITE 170",
            "city": "ARNOLD",
            "state": "MO",
            "postal_code": "63010",
            "telephone_number": "636-717-6776",
            "fax_number": "314-525-4055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHITWOOD",
        "first_name": "MARY",
        "middle_name": "BETH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-28",
        "last_updated": "2013-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2002014087",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "WEICK",
            "middle_name": "BETH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Arnold, MO

Sources for this page

Verify at the official NPI Registry.