Individual provider Active NPI

Edward Lothar Fieg, DO

  • Emergency Medicine Physician
  • Wright Patterson Afb, OH
National Provider Identifier
1609862523
Registry record updated Aug 6, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
3073 Issued in IA
Practice address
4881 Sugar Maple Dr
Wright Patterson Afb, OH 45433-5546
Phone
(937) 257-8838
NPI assigned
Sep 26, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 3073 IA Primary
Family Medicine Physician 207Q00000X 3073 IA

Addresses

Primary practice location

4881 Sugar Maple Dr
Wright Patterson Afb, OH 45433-5546

Mailing address

2896 Calle de Cordoba
Fairfield, CA 94534-7878
Phone (707) 422-2953

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, MO2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20120323000419 OH Practitioner - Emergency Medicine 0143480459 Reassigns benefits to 1 organization
I20150521000097 MO Practitioner - Emergency Medicine 0143480459 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 1995
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)

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

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3073IAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Emergency Physicians of Memphis LLC Emergency Medicine CurrentSince Aug 22, 2018 Accepting new patients
Emergency Professional Services, Inc. Emergency Medicine CurrentSince Mar 1, 2012 Accepting new patients
SLH Physicians LLC Emergency Medicine CurrentSince Sep 1, 2015 Accepting new patients
Camden Emergency Group LLC Emergency Medicine CurrentSince Jun 28, 2016 Accepting new patients
SSM Health Care Group CurrentSince Dec 19, 2023 Accepting new patients
SSM Health Care Group Emergency Medicine CurrentSince Dec 19, 2023 Accepting new patients

Locations

1600 E Broadway
Columbia, MO 65201
Phone (573) 632-5000

54 Hospital Dr
Osage Beach, MO 65065
Phone (573) 280-2772

1201 S Grand Blvd
Saint Louis, MO 63104
Phone (314) 257-8222

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

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

18697 Bagley Rd
Middleburg Heights, OH 44130
Phone (440) 816-8000

Interoperability endpoints

  • Direct secure messaging: efieg236534@direct-ehr-ssmhc.com

Organizations & group practices 6

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": "1127692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1249516800000",
    "number": "1609862523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2896 CALLE DE CORDOBA",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945347878",
            "telephone_number": "707-422-2953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4881 SUGAR MAPLE DR",
            "city": "WRIGHT PATTERSON AFB",
            "state": "OH",
            "postal_code": "454335546",
            "telephone_number": "937-257-8838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIEG",
        "first_name": "EDWARD",
        "middle_name": "LOTHAR",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-26",
        "last_updated": "2009-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IA",
            "license": "3073",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "3073",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wright Patterson Afb, OH

Sources for this page

Verify at the official NPI Registry.