NPIMap

Individual provider Active NPI

Richard Christopher Muckerman II, MD

  • Obstetrics Physician
  • Chesterfield, MO
National Provider Identifier
1649219569
Registry record updated Oct 16, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics PhysicianTaxonomy code 207VX0000X
License
R8639 Issued in MO
Practice address
16216 Baxter Rd
Suite 100
Chesterfield, MO 63017-4770
Phone
(636) 449-4700
Fax
(636) 449-2596
NPI assigned
Jun 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics Physician 207VX0000X R8639 MO Primary

Addresses

Primary practice location

16216 Baxter Rd
Suite 100
Chesterfield, MO 63017-4770

Mailing address

16216 Baxter Rd
Suite 100
Chesterfield, MO 63017-4770
Phone (636) 449-4700

Other identifiers 4

IdentifierTypeStateIssuer
20799OtherMOB N D D NUMBER
AM8351443OtherD E A NUMBER
23394OtherA B O G
R8639OtherMOMEDICAL LICENSE, PHY&SURG

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111123000027 MO Practitioner - Obstetrics/Gynecology 8325934490 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Georgetown University School of Medicine, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

16216 Baxter Rd
Chesterfield, MO 63017-4778
Phone (636) 449-4700

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R8639MOMDObstetrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
McPherson Medical & Diagnostic, LLC CurrentSince Jan 3, 2024 Accepting new patients
McPherson Medical & Diagnostic LLC CurrentSince Jan 3, 2024 Accepting new patients
McPherson Medical & Diagnostic, LLC Current Accepting new patients
McPherson Medical & Diagnostic, LLC Past Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

16216 Baxter Rd
Ste 100
Chesterfield, MO 63017
Phone (636) 449-4700

10345 Watson Rd
Saint Louis, MO 63127
Phone (314) 384-3584

216 W Main St
Steele, MO 63877
Phone (573) 695-2181

216 W Main St
Ste B
Steele, MO 63877
Phone (573) 695-2181

Organizations & group practices 5

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 3

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": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192492800000",
    "number": "1649219569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16216 BAXTER RD",
            "address_2": "SUITE 100",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630174770",
            "telephone_number": "636-449-4700",
            "fax_number": "636-449-2596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16216 BAXTER RD",
            "address_2": "SUITE 100",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630174770",
            "telephone_number": "636-449-4700",
            "fax_number": "636-449-2596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUCKERMAN",
        "first_name": "RICHARD",
        "middle_name": "CHRISTOPHER",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2007-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VX0000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": "MO",
            "license": "R8639",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "B N D D NUMBER",
            "identifier": "20799",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "D E A NUMBER",
            "identifier": "AM8351443",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "A B O G",
            "identifier": "23394",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE, PHY&SURG",
            "identifier": "R8639",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesterfield, MO

Sources for this page

Verify at the official NPI Registry.