NPIMap

Organization Active NPI

St. Anthony'S Physician Organization

  • Internal Medicine Physician
  • Saint Louis, MO
National Provider Identifier
1497088082
Registry record updated Jan 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
106241 Issued in MO
Legal business name
ST. ANTHONY'S PHYSICIAN ORGANIZATION
Practice address
12700 Southfork Rd
Ste 200 & 220
Saint Louis, MO 63128-3201
Phone
(314) 543-5942
Fax
(314) 543-5947
NPI assigned
Sep 14, 2009
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
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X 106241 MO Primary

Addresses

Primary practice location

12700 Southfork Rd
Ste 200 & 220
Saint Louis, MO 63128-3201

Mailing address

12700 Southfork Rd
Ste.200 & 220
Saint Louis, MO 63128-3201
Phone (314) 543-5942

Other names 1

  • Mercy Clinic South Physicians Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1252886400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1546560000000",
    "number": "1497088082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12700 SOUTHFORK RD",
            "address_2": "STE.200 & 220",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631283201",
            "telephone_number": "314-543-5942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12700 SOUTHFORK RD",
            "address_2": "STE 200 & 220",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631283201",
            "telephone_number": "314-543-5942",
            "fax_number": "314-543-5947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. ANTHONY'S PHYSICIAN ORGANIZATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-14",
        "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": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "106241",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mercy Clinic South Physicians",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Saint Louis, 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.