NPIMap

Organization Active NPI

St. Anthony's Physician Organization

Doing business as Mercy Clinic South Physicians

  • Family Medicine Physician
  • Fenton, MO
National Provider Identifier
1467648634
Registry record updated Jan 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ST. ANTHONY'S PHYSICIAN ORGANIZATION
Doing business as
Mercy Clinic South Physicians
Practice address
714 Gravois Rd
Ste 210
Fenton, MO 63026-7723
Phone
(314) 543-5230
Fax
(636) 717-6730
NPI assigned
Sep 20, 2007
Last updated
Jan 4, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2019

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

Authorized official

Name
Ms. Cheryl Matejka
Title
Cfo East Communities & Sfo
Phone
(314) 251-1958

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

714 Gravois Rd
Ste 210
Fenton, MO 63026-7723

Mailing address

714 Gravois Rd
Ste 210
Fenton, MO 63026-7723
Phone (314) 543-5230

Other names 1

  • Mercy Clinic South Physicians Doing business as

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1190246400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1546560000000",
    "number": "1467648634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "714 GRAVOIS RD",
            "address_2": "STE 210",
            "city": "FENTON",
            "state": "MO",
            "postal_code": "630267723",
            "telephone_number": "314-543-5230",
            "fax_number": "636-717-6730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "714 GRAVOIS RD",
            "address_2": "STE 210",
            "city": "FENTON",
            "state": "MO",
            "postal_code": "630267723",
            "telephone_number": "314-543-5230",
            "fax_number": "636-717-6730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. ANTHONY'S PHYSICIAN ORGANIZATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-20",
        "last_updated": "2019-01-04",
        "status": "A",
        "authorized_official_last_name": "MATEJKA",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_title_or_position": "CFO EAST COMMUNITIES & SFO",
        "authorized_official_telephone_number": "314-251-1958",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mercy Clinic South Physicians",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fenton, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2019; 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.