Individual provider Active NPI

Alexandra Johnson, MD

  • Obstetrics & Gynecology Physician
  • Saint Louis, MO
National Provider Identifier
1609300888
Registry record updated May 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
2024011192 Issued in MO
Practice address
621 S New Ballas Rd Ste 1017B
Saint Louis, MO 63141-8264
Phone
(314) 292-7080
NPI assigned
Apr 14, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 288349 MA
Obstetrics & Gynecology Physician 207V00000X 2024011192 MO Primary

Addresses

Primary practice location

621 S New Ballas Rd Ste 1017B
Saint Louis, MO 63141-8264

Mailing address

PO Box 776084
Chicago, IL 60677-6084
Phone (314) 292-7080

Other practice location 1

55 Fruit St
Boston, MA 02114-2696
Phone (417) 350-8752

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
I20240531002619 MO Practitioner - Obstetrics/Gynecology 6103195169 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Missouri, Kansas City, School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic East CommunitiesGroup PAC ID 7214827922, 573 clinicians

Practice addresses (Care Compare)

621 S New Ballas Rd
Suite 1017B
Saint Louis, MO 63141-8264
Phone (314) 292-7080

Hospital & facility affiliations

  • Mercy Hospital St Louis Hospital, Saint Louis, MO, CCN 260020

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic East Communities Obstetrics & Gynecology CurrentSince Jun 2, 2024 Accepting new patients
Mercy Hospitals East Communities CurrentSince Apr 16, 2025 Accepting new patients
Mercy Hospitals East Communities CurrentSince Apr 16, 2025 Accepting new patients
Mercy Hospitals East Communities Past Accepting new patients

Locations

621 S New Ballas Rd
Ste 189A
Saint Louis, MO 63141
Phone (314) 251-6335

621 S New Ballas Rd
Ste 4017B
Saint Louis, MO 63141
Phone (314) 872-9192

615 S New Ballas Rd
Saint Louis, MO 63141
Phone (314) 251-4687

621 S New Ballas Rd
Ste 1017B
Saint Louis, MO 63141
Phone (314) 292-7080

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1492128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716422400000",
    "number": "1609300888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776084",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606776084",
            "telephone_number": "314-292-7080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 S NEW BALLAS RD STE 1017B",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418264",
            "telephone_number": "314-292-7080"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "55 Fruit St",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021142696",
            "country_code": "US",
            "telephone_number": "417-350-8752",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ALEXANDRA",
        "name_prefix": "Miss",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-14",
        "last_updated": "2024-05-23",
        "certification_date": "2024-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MA",
            "license": "288349",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MO",
            "license": "2024011192",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.