Individual provider Active NPI

Jack Anthony Galbraith, MD

  • Family Medicine Physician
  • Saint Louis, MO
National Provider Identifier
1649373440
Registry record updated Apr 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2008025165 Issued in MO
Practice address
3630 S Geyer Rd Ste 320
Saint Louis, MO 63127-1234
Phone
(314) 996-4900
Fax
(314) 996-4901
NPI assigned
Sep 7, 2006
Last updated
Apr 7, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2008025165 MO Primary
Family Medicine Physician 207Q00000X T2006016537 MO

Addresses

Primary practice location

3630 S Geyer Rd Ste 320
Saint Louis, MO 63127-1234

Mailing address

PO Box 959354
Saint Louis, MO 63195-9354
Phone (314) 448-3791

Other practice location 1

5425 Southfield Ctr
Saint Louis, MO 63123-5984
Phone (314) 543-5258

Other practice location 2

13303 Tesson Ferry Rd Ste 45
Saint Louis, MO 63128-4062
Phone (314) 748-5917

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2 Health Information Exchange (HIE)

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
I20090213000462 MO Practitioner - Family Practice 4789749367 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Physician Groups LCGroup PAC ID 3072421254, 526 clinicians

Practice addresses (Care Compare)

1110 Highlands Plaza Dr E
Saint Louis, MO 63110-1351
Phone (314) 273-0195

2630 Hwy K
O Fallon, MO 63368-6624
Phone (636) 240-5454

3009 N Ballas Rd
Suite 227a
Saint Louis, MO 63131-2308
Phone (314) 996-7800

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2008025165MOMDFamily Medicine Physician
T2006016537MOMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Physician Groups LC Family Medicine CurrentSince Aug 31, 2024 Accepting new patients
Physician Groups LC CurrentSince Aug 31, 2024 Accepting new patients

Locations

2630 Highway K
O Fallon, MO 63368
Phone (636) 240-5454

3009 N Ballas Rd
Ste 226A
Saint Louis, MO 63131
Phone (314) 432-5555

660 Mason Ridge Center Dr
Ste 300
Saint Louis, MO 63141
Phone (314) 463-6950

Interoperability endpoints

  • Direct secure messaging: jack.galbraith.p1@direct.essehealth.nextgenshare.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1157587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775520000000",
    "number": "1649373440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 959354",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631959354",
            "telephone_number": "314-448-3791",
            "fax_number": "314-996-7658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3630 S GEYER RD STE 320",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631271234",
            "telephone_number": "314-996-4900",
            "fax_number": "314-996-4901"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5425 Southfield Ctr",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631235984",
            "country_code": "US",
            "telephone_number": "314-543-5258",
            "fax_number": "314-543-5262",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "13303 Tesson Ferry Rd Ste 45",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631284062",
            "country_code": "US",
            "telephone_number": "314-748-5917",
            "fax_number": "314-748-5919",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GALBRAITH",
        "first_name": "JACK",
        "middle_name": "ANTHONY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-07",
        "last_updated": "2026-04-07",
        "certification_date": "2026-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2008025165",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "T2006016537",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2",
            "affiliation": "N",
            "endpointDescription": "BJC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3630 S Geyer Rd Ste 320",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631271234",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.