Meramec Valley OBGYN Inc

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

R5C65 Issued in MO

Legal business name

MERAMEC VALLEY OBGYN INC

Practice address

408 Gravois Rd
Fenton, MO 63026

Phone

(636) 343-1144

Fax

(636) 343-6624

NPI assigned

Apr 10, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Jack E Ricketts, MD

Title

Owner President

Phone

(636) 343-1144

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203984000000",
    "number": "1437372364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 824",
            "city": "FENTON",
            "state": "MO",
            "postal_code": "63026",
            "telephone_number": "636-343-1144",
            "fax_number": "636-343-6624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 GRAVOIS RD",
            "city": "FENTON",
            "state": "MO",
            "postal_code": "63026",
            "telephone_number": "636-343-1144",
            "fax_number": "636-343-6624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERAMEC VALLEY OBGYN INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-10",
        "last_updated": "2008-02-26",
        "status": "A",
        "authorized_official_last_name": "RICKETTS",
        "authorized_official_first_name": "JACK",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER PRESIDENT",
        "authorized_official_telephone_number": "636-343-1144",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "MO",
            "license": "R5C65",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jason Michael Mehrtens, MD
• Gary E. Meier, P.T.
• John Mellas, MD
• Ashley Menard, MA, LPC
• Stephen Menzel, O.D.
• Brian James Mercier, PHARMD
• Mercy Health Services, LLC
• Mercy Hospital South
• Mercy Pharmacy Services LLC
• Kurt D Merkel, M.D.

• Obstetrics & Gynecology Physician in Fenton, MO
• Providers in Fenton, MO by specialty
• Obstetrics & Gynecology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.