Individual provider Active NPI

Nicole L Meyer, DO

  • Pediatric Emergency Medicine (Pediatrics) Physician
  • Saint Louis, MO
National Provider Identifier
1578181228
Registry record updated Jun 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Emergency Medicine (Pediatrics) PhysicianTaxonomy code 2080P0204X
License
2023013136 Issued in MO
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

Updated by the provider on Jun 19, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250626000910 MO Practitioner - Emergency MedicinePractitioner - Pediatric Medicine 6305358102 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2020019024MOMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
SSM Health Care St Louis CurrentSince Nov 1, 2025 Accepting new patients
SSM Health Care Group CurrentSince Jul 1, 2025 Accepting new patients
SSM Health Care Group Pediatrics CurrentSince Jul 1, 2025 Accepting new patients
SSM Health Care St. Louis CurrentSince Nov 1, 2025 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

  • Direct secure messaging: 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.

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

Verify at the official NPI Registry.