Faith Grove, MD
Individual provider Active NPI Family Medicine Physician · Perryville, MO
NPI 1457046526 · NPPES record last updated Jul 14, 2026
Key facts
- NPI
- 1457046526
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 2026033289 (MO)
- Practice address
- 212 Hospital LN Ste 101B
Perryville, MO 63775-4204 - Phone
- (573) 547-7888
- NPI assigned
- Apr 5, 2023
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230811001606 | IL | Order and Referring Only - Family Practice |
1759743438 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mercy Hospital Perry | Family Medicine | Past | Accepting new patients |
| Mercy Hospital Perry | Family Medicine | Past | Accepting new patients |
Interoperability endpoints
- fkapp149977@uihealth.direct-ci.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 2026033289 | MO | Yes |
Addresses
Primary practice location
212 Hospital LN Ste 101B
Perryville, MO 63775-4204
Mailing address
212 Hospital LN Ste 101B
Perryville, MO 63775-4204
Other providers in Perryville, MO
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- Maripat L Gatter
- Kelly Gerrein
- Sherry Ann Goshen
- Darryl A Green
- Mary Hadler
- Kelley Haertilng
- Dominic Jeffrey Haertling
- Amanda Sue Hager
- Bruce E Harrison
All providers in Perryville, MO · Family Medicine Physician in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 14, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.