Individual provider Active NPI

Shirley N Okwuashi, M.D.

  • Internal Medicine Physician
  • Saint Louis, MO
National Provider Identifier
1417247693
Registry record updated Mar 15, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2015014965 Issued in MO
Practice address
10010 Kennerly Rd
3 Southbridge
Saint Louis, MO 63128-2106
Phone
(314) 525-1328
Fax
(314) 525-1378
NPI assigned
Apr 8, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2017

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X Q4661 TX
Pediatrics Physician 208000000X Q4661 TX
Internal Medicine Physician 207R00000X 2015014965 MO Primary
Pediatrics Physician 208000000X 2015014965 MO

Addresses

Primary practice location

10010 Kennerly Rd
3 Southbridge
Saint Louis, MO 63128-2106

Mailing address

10010 Kennerly Rd
3 Southbridge
Saint Louis, MO 63128-2106
Phone (314) 525-1328

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
I20161012000677 MO Practitioner - Internal MedicinePractitioner - Pediatric Medicine 1153638549 Reassigns benefits to 8 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Texas Medical School at San Antonio, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

10010 Kennerly Rd
Saint Louis, MO 63128-2106
Phone (314) 525-1899

10018 Kennerly Rd
Saint Louis, MO 63128-2106
Phone (314) 525-3423

Hospital & facility affiliations

  • Mercy Hospital South Hospital, Saint Louis, MO, CCN 260077

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
Q4661TXMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Adult Hospitalists - St. Louis, LLC Internal Medicine CurrentSince Dec 30, 2019 Accepting new patients
Mercy Hospitals East Communities CurrentSince Aug 14, 2018 Accepting new patients
Mercy Hospitals East Communities Internal Medicine CurrentSince Dec 30, 2019 Accepting new patients
Mercy Hospital South CurrentSince Jan 1, 2020 Accepting new patients
Mercy Clinic Adult Hospitalists - Washington, LLC CurrentSince Dec 30, 2019 Accepting new patients
Mercy Hospital South CurrentSince Jan 1, 2020 Accepting new patients
Mercy Clinic Adult Hospitalists- Jefferson, LLC Internal Medicine CurrentSince Dec 30, 2019 Accepting new patients
Mercy Hospitals East Communities CurrentSince Aug 14, 2018 Accepting new patients
St Anthonys Physician Organization Hospitalist Services, L.C. CurrentSince Nov 1, 2016 Accepting new patients
Mercy Hospital Lincoln Internal Medicine CurrentSince Dec 30, 2019 Accepting new patients
Seasons Hospice & Palliative Care of Missouri, LLC PastSince Nov 1, 2020 Accepting new patients

Locations

1400 US Highway 61
Crystal Cty, MO 63028
Phone (636) 933-1111

714 Gravois Rd
Ste 100
Fenton, MO 63026
Phone (636) 326-6100

10010 Kennerly Rd
Saint Louis, MO 63128
Phone (314) 525-1328

615 S New Ballas Rd
Saint Louis, MO 63141
Phone (314) 251-4687

615 S New Ballas Rd
#H
Saint Louis, MO 63141
Phone (314) 251-6075

10010 Kennerly Rd
#3
Saint Louis, MO 63128
Phone (314) 525-1328

900 E Cherry St
Troy, MO 63379
Phone (636) 528-8585

901 E 5th St
Washington, MO 63090
Phone (636) 239-8000

Organizations & group practices 11

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 1

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": "1302220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489536000000",
    "number": "1417247693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10010 KENNERLY RD",
            "address_2": "3 SOUTHBRIDGE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282106",
            "telephone_number": "314-525-1328",
            "fax_number": "314-525-1378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10010 KENNERLY RD",
            "address_2": "3 SOUTHBRIDGE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282106",
            "telephone_number": "314-525-1328",
            "fax_number": "314-525-1378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OKWUASHI",
        "first_name": "SHIRLEY",
        "middle_name": "N",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-08",
        "last_updated": "2017-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "Q4661",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "Q4661",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2015014965",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "2015014965",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.