Active NPI
Melody Santos, M.D.
- Pediatrics Physician
- Swansea, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- Practice address
- 3 Park PL
Swansea, IL 62226-2965 - Phone
- (618) 222-9244
- Fax
- (618) 222-9248
- NPI assigned
- Jul 17, 2006
- Last updated
- Jul 9, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 2000146144 | MO | |
| Pediatrics Physician | 208000000X | IL | Primary |
Addresses
Primary practice location
3 Park PL
Swansea, IL 62226-2965
Mailing address
7980 Clayton Rd
Suite 202
Saint Louis, MO 63117-1354
Phone (314) 951-5368
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-100672 | IL | MD | Pediatrics Physician |
| 2000146144 | MO | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| SSM Medical Group Inc. | Current | Accepting new patients | |
| SSM Medical Group, Inc. | Current | Accepting new patients | |
| SSM Health Care St. Louis | Pediatrics | Past | Accepting new patients |
| SSM Depaul Medical Group, Inc. | Pediatrics | Past | Accepting new patients |
Locations
705 S Grand St
Nashville, IL 62263
Phone (618) 327-2200
1551 Wall St
Ste 310
Saint Charles, MO 63303
Phone (636) 669-2268
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba SSM Health Medical Group
- Multi-Specialty Clinic/Center
- Fenton, MO
- NPI 1700966207
IL
-
dba SSM Health Medical Group
- Durable Medical Equipment & Medical Supplies
- Warrenton, MO
- NPI 1467997155
-
dba SSM Health Medical Group
- Internal Medicine Physician
- Maryland Heights, MO
- NPI 1760456743
Pediatrics
-
dba SSM Health St. Joseph Hospital - St. Charles Physician Billing
- Emergency Medicine Physician
- Saint Charles, MO
- NPI 1427002922
Pediatrics
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153094400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1487672903",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7980 CLAYTON RD",
"address_2": "SUITE 202",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631171354",
"telephone_number": "314-951-5368",
"fax_number": "314-951-5238"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3 PARK PL",
"city": "SWANSEA",
"state": "IL",
"postal_code": "622262965",
"telephone_number": "618-222-9244",
"fax_number": "618-222-9248"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANTOS",
"first_name": "MELODY",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-17",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MO",
"license": "2000146144",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Swansea, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.