Active NPI
Martin Barry McClintock, MD
- Family Medicine Physician
- Ballwin, MO
National Provider Identifier
1427046366
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- R7737
- Practice address
- 15421 Clayton Rd
Suite G-2
Ballwin, MO 63011-3161 - Phone
- (636) 227-2707
- Fax
- (636) 227-1216
- NPI assigned
- Oct 13, 2005
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | R7737 | MO | Primary |
Addresses
Primary practice location
15421 Clayton Rd
Suite G-2
Ballwin, MO 63011-3161
Mailing address
15421 Clayton Rd
Suite G-2
Ballwin, MO 63011-3161
Phone (636) 227-2707
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100918000231 | MO | Practitioner - Family Practice | 0244355857 | Practice locations: Ballwin, MO |
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Saint Louis University School of Medicine, 1976
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
15421 Clayton Rd
G2
Ballwin, MO 63011-3161
Phone (636) 227-2707
Hospital & facility affiliations
- St Luke'S Home Health Services
- St Lukes Hospital
- Missouri Baptist Medical Center
- Mercy Hospital St Louis
- SSM Health Rehabilitation Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal or shaving of skin growth | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Saint Louis, MO
- NPI 1427098169
-
- General Acute Care Hospital
- Saint Louis, MO
- NPI 1487663506
-
- Rehabilitation Hospital
- Richmond Heights, MO
- NPI 1659511988
Inpatient rehabilitation facility
-
- General Acute Care Hospital
- Chesterfield, MO
- NPI 1346251543
-
- Home Health Agency
- Chesterfield, MO
- NPI 1720220858
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1129161600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1335830400000",
"number": "1427046366",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15421 CLAYTON RD",
"address_2": "SUITE G-2",
"city": "BALLWIN",
"state": "MO",
"postal_code": "630113161",
"telephone_number": "636-227-2707",
"fax_number": "636-227-1216"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15421 CLAYTON RD",
"address_2": "SUITE G-2",
"city": "BALLWIN",
"state": "MO",
"postal_code": "630113161",
"telephone_number": "636-227-2707",
"fax_number": "636-227-1216"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCLINTOCK",
"first_name": "MARTIN",
"middle_name": "BARRY",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-10-13",
"last_updated": "2012-05-01",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MO",
"license": "R7737",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ballwin, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.