NPIMap

Individual provider Active NPI

Julie K Gammack, MD

  • Geriatric Medicine (Internal Medicine) Physician
  • Saint Louis, MO
National Provider Identifier
1518975366
Registry record updated Mar 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
2003020128 Issued in MO
Practice address
Center for Specialized Medicine
1221 S. Grand Blvd, 2ND Floor
St Louis, MO 63104
Phone
(314) 977-6055
Fax
(314) 977-3370
NPI assigned
Aug 4, 2006
Last updated
Mar 11, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 2003020128 MO Primary

Addresses

Primary practice location

Center for Specialized Medicine
1221 S. Grand Blvd, 2ND Floor
St Louis, MO 63104

Mailing address

1008 S Spring Ave FL 2
Saint Louis, MO 63110-2520
Phone (314) 977-8462

Other practice location 1

SSM-St. Lous Universith Hospital
1201 S. Grand Blvd
St. Louis, MO 63104
Phone (314) 977-8462

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address jgammack236561@direct-ehr-ssmhc.com Direct
FHIR URL http://fhir.ssmhc.com/fhir/api/FHIR/DSTU2 Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050128000630 MO Practitioner - Geriatric MedicinePractitioner - Internal Medicine 1850341603 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Geriatric MedicineAlso: Internal Medicine
Education
University of Minnesota Medical School, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SSM Health Care GroupGroup PAC ID 0143608372, 929 clinicians

Practice addresses (Care Compare)

10101 Woodfield LN
Saint Louis, MO 63132-2946
Phone (608) 280-4647

1201 S Grand Blvd
Saint Louis, MO 63104-1016
Phone (314) 617-2000

1225 S Grand Blvd
Saint Louis, MO 63104-1016

7920 Clayton Rd
Saint Louis, MO 63117-1327
Phone (314) 366-4768

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.94 of 100Reported as group
Quality
68.52
Promoting interoperability
100
Improvement activities
40
Cost
72.22

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
SSM Health Care Group CurrentSince Jul 1, 2022 Accepting new patients
SSM Health Care Group CurrentSince Jul 1, 2022 Accepting new patients
C.M.C. Extended Care Center, Inc. Past Accepting new patients
SSM Medical Group Inc. Past Accepting new patients
Baylor College of Medicine Past Accepting new patients

Locations

10101 Woodfield Ln
Saint Louis, MO 63132
Phone (608) 280-4647

1201 S Grand Blvd
Saint Louis, MO 63104
Phone (314) 257-1320

3635 Vista Ave
Saint Louis, MO 63110
Phone (314) 577-8022

3691 Rutger St
Saint Louis, MO 63110
Phone (314) 268-4101

Interoperability endpoints

  • Direct secure messaging: jgammack236561@direct-ehr-ssmhc.com

Organizations & group practices 5

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.

Hospital & facility affiliations 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615420800000",
    "number": "1518975366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1008 S SPRING AVE FL 2",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631102520",
            "telephone_number": "314-977-8462",
            "fax_number": "314-977-3370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CENTER FOR SPECIALIZED MEDICINE",
            "address_2": "1221 S. GRAND BLVD, 2ND FLOOR",
            "city": "ST LOUIS",
            "state": "MO",
            "postal_code": "63104",
            "telephone_number": "314-977-6055",
            "fax_number": "314-977-3370"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "SSM-St. Lous Universith Hospital",
            "address_2": "1201 S. Grand Blvd",
            "address_purpose": "LOCATION",
            "city": "ST. LOUIS",
            "state": "MO",
            "postal_code": "63104",
            "country_code": "US",
            "telephone_number": "314-977-8462",
            "fax_number": "314-977-3370",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GAMMACK",
        "first_name": "JULIE",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-04",
        "last_updated": "2021-03-11",
        "certification_date": "2021-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "MO",
            "license": "2003020128",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jgammack236561@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "jgammack236561@direct-ehr-ssmhc.com",
            "address_1": "SSM-St. Lous Universith Hospital",
            "address_2": "1201 S. Grand Blvd",
            "city": "ST. LOUIS",
            "state": "MO",
            "country_code": "US",
            "postal_code": "63104",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "http://fhir.ssmhc.com/fhir/api/FHIR/DSTU2",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Saint Louis",
            "address_1": "SSM-St. Lous Universith Hospital",
            "address_2": "1201 S. Grand Blvd",
            "city": "ST. LOUIS",
            "state": "MO",
            "country_code": "US",
            "postal_code": "63104",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.