Active NPI
Nicole L Meyer, DO
- Pediatric Emergency Medicine (Pediatrics) Physician
- Saint Louis, MO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Emergency Medicine (Pediatrics) Physician
- License
- 2023013136
- Practice address
- 1465 S Grand Blvd
Saint Louis, MO 63104-1003 - Phone
- (314) 617-2000
- NPI assigned
- Jul 9, 2020
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pediatric Emergency Medicine (Pediatrics) Physician | 2080P0204X | 2023013136 | MO | Primary |
| Pediatrics Physician | 208000000X | 2020019024 | MO |
Addresses
Primary practice location
1465 S Grand Blvd
Saint Louis, MO 63104-1003
Mailing address
400 N Keene St
Columbia, MO 65201-6626
Phone (573) 882-4438
Other practice location 1
404 N Keene St
Columbia, MO 65201-6626
Phone (573) 882-4438
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
- 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 Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2020019024 | MO | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| SSM Health Care St Louis | Current | Accepting new patients | |
| SSM Health Care Group | Current | Accepting new patients | |
| SSM Health Care Group | Pediatrics | Current | Accepting new patients |
| SSM Health Care St. Louis | Current | Accepting new patients |
Locations
7344 Solutions Ctr
Chicago, IL 60677
Phone (314) 989-6189
1015 Bowles Ave
Fenton, MO 63026
Phone (636) 496-2000
300 1st Capitol Dr
Saint Charles, MO 63301
Phone (636) 669-2211
1465 S Grand Blvd
Saint Louis, MO 63104
Phone (314) 268-4070
1145 Corporate Lake Dr
Saint Louis, MO 63132
Phone (314) 989-6189
10101 Woodfield Ln
Saint Louis, MO 63132
Phone (608) 280-4647
Interoperability endpoints
- nmeyer314729@direct-ehr-ssmhc.com
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 and National Provider Directory roles.
-
dba SLUCare Physician Group
- Internal Medicine Physician
- Saint Louis, MO
- NPI 1306589544
Pediatrics
-
dba SSM Health St Clare Fenton
- Emergency Medicine Physician
- Fenton, MO
- NPI 1275586174
-
dba SLUCare Physician Group
- Dermatopathology Physician
- Saint Louis, MO
- NPI 1932844495
-
dba SSM Health DePaul Hospital
- Cardiovascular Disease Physician
- Bridgeton, MO
- NPI 1376598599
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1594252800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1750291200000",
"number": "1578181228",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "400 N KEENE ST",
"city": "COLUMBIA",
"state": "MO",
"postal_code": "652016626",
"telephone_number": "573-882-4438"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1465 S GRAND BLVD",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631041003",
"telephone_number": "314-617-2000"
}
],
"practiceLocations": [
{
"address_1": "404 N Keene St",
"address_purpose": "LOCATION",
"city": "Columbia",
"state": "MO",
"postal_code": "652016626",
"country_code": "US",
"telephone_number": "573-882-4438",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MEYER",
"first_name": "NICOLE",
"middle_name": "L",
"credential": "DO",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-07-09",
"last_updated": "2025-06-19",
"certification_date": "2025-06-19",
"status": "A"
},
"taxonomies": [
{
"code": "2080P0204X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Emergency Medicine",
"state": "MO",
"license": "2023013136",
"primary": true
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MO",
"license": "2020019024",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
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 Jun 19, 2025; 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.