Individual provider Active NPI

Michael Joseph Ripple, MD PHD

  • Pediatrics Physician
  • Saint Louis, MO
National Provider Identifier
1407376346
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
2017019513 Issued in MO
Practice address
1 Childrens PL # 3S34
Saint Louis, MO 63110-1002
Phone
(314) 454-6006
Fax
(314) 454-4102
NPI assigned
Jun 21, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 2017019513 MO Primary

Addresses

Primary practice location

1 Childrens PL # 3S34
Saint Louis, MO 63110-1002

Mailing address

1 Childrens PL # 3S34
Saint Louis, MO 63110-1002
Phone (314) 454-6006

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20240723000730 GA Practitioner - Pediatric Medicine 0143642512 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2017019513MOMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Choa Hospital Based, LLC Pediatrics CurrentSince May 10, 2024 Accepting new patients
Choa Multispecialty, LLC Pediatrics Current Accepting new patients
Egleston Pediatric Group Pediatrics Current Accepting new patients
Egleston Children'S Hospital at Emory University, Inc. Past Accepting new patients
Arthur M. Blank Hospital, Inc. Past Accepting new patients

Locations

1405 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 785-1112

Organizations & group practices 5

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": "1498003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1407376346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CHILDRENS PL # 3S34",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101002",
            "telephone_number": "314-454-6006",
            "fax_number": "314-454-4102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CHILDRENS PL # 3S34",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101002",
            "telephone_number": "314-454-6006",
            "fax_number": "314-454-4102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIPPLE",
        "first_name": "MICHAEL",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "MD PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-06-21",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "2017019513",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.