NPIMap

Organization Active NPI

Missouri Baptist Medical Center

  • Physician Assistant
  • Saint Louis, MO
National Provider Identifier
1558370528
Registry record updated Jan 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Legal business name
MISSOURI BAPTIST MEDICAL CENTER
Practice address
3015 N Ballas Rd
Saint Louis, MO 63131-2329
Phone
(314) 996-5000
Fax
(314) 996-3610
NPI assigned
Aug 7, 2006
Last updated
Jan 20, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2023

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

Authorized official

Name
Ms. Ann Abad
Title
President
Phone
(314) 996-8401

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X
Physician Assistant 363A00000X Primary
General Practice Physician 208D00000X

Addresses

Primary practice location

3015 N Ballas Rd
Saint Louis, MO 63131-2329

Mailing address

3015 N Ballas Rd
Saint Louis, MO 63131-2329
Phone (314) 996-5000

Other identifiers 6

IdentifierTypeStateIssuer
5000192OtherUNITED HEALTHCARE
0536913OtherAETNA HMO
010419307MedicaidMO
109OtherBLUE CROSS
6350715OtherAETNA PPO
103189OtherHEALTHLINK

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050720000569 MO Part B Supplier - Clinic/Group Practice 3476461955 Receives reassigned benefits from 15 practitioners
Practice locations: Saint Louis, MO

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Ownership & related parties

All facility ownership & control disclosures 12

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Parkland Health Center - FarmingtonFarmington, MO, CCN 260163 Hospital Operational/Managerial Control Jun 2, 1994
Missouri Baptist Medical CenterSaint Louis, MO, CCN 260108 Hospital Operational/Managerial Control Jun 2, 1994
Missouri Baptist Sullivan HospitalSullivan, MO, CCN 261337 Hospital Operational/Managerial Control Oct 15, 2002
Missouri Baptist Sullivan HospitalSullivan, MO, CCN 26Z337 Hospital Operational/Managerial Control Oct 15, 2002
Missouri Baptist Sullivan HospitalSullivan, MO, CCN 26M337 Hospital Operational/Managerial Control Oct 15, 2002
Parkland Health Center - Bonne TerreBonne Terre, MO, CCN 260779 Hospital Operational/Managerial Control Jun 2, 1994
Missouri Baptist Cuba Medical OfficeCuba, MO, CCN 263407 Rural health clinic Operational/Managerial Control Jun 2, 1994
Sullivan Medical OfficeSullivan, MO, CCN 263487 Rural health clinic Operational/Managerial Control Jun 2, 1994
Bourbon Medical OfficeBourbon, MO, CCN 268527 Rural health clinic Operational/Managerial Control Jun 2, 1994
Missouri Baptist Steelville OfficeSteelville, MO, CCN 268528 Rural health clinic Operational/Managerial Control Jun 2, 1994
Parkland Health Center Medical ClinicFarmington, MO, CCN 268794 Rural health clinic Operational/Managerial Control Jun 1, 1993
Parkland Health Center Primary Care ClinicFarmington, MO, CCN 268807 Rural health clinic Operational/Managerial Control Jun 1, 1993

Owned or controlled facilities with NPI records 14

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

View all 14

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1154908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674172800000",
    "number": "1558370528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3015 N BALLAS RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631312329",
            "telephone_number": "314-996-5000",
            "fax_number": "314-996-3610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3015 N BALLAS RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631312329",
            "telephone_number": "314-996-5000",
            "fax_number": "314-996-3610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSOURI BAPTIST MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-07",
        "last_updated": "2023-01-20",
        "certification_date": "2023-01-20",
        "status": "A",
        "authorized_official_last_name": "ABAD",
        "authorized_official_first_name": "ANN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "314-996-8401",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "5000192",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "0536913",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010419307",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "109",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO",
            "identifier": "6350715",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "103189",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "BJC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3015 N Ballas Rd",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631312329",
            "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.