NPIMap

Individual provider Active NPI

Rachel Meenu George, MD

  • Internal Medicine Physician
  • Fenton, MO
National Provider Identifier
1679546592
Registry record updated Oct 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
108366 Issued in MO
Practice address
1345 Smizer Mill Rd Ste 1100
Fenton, MO 63026-7305
Phone
(636) 496-5022
NPI assigned
Feb 10, 2006
Last updated
Oct 21, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 108366 MO Primary
Hospitalist Physician 208M00000X 108366 MO

Addresses

Primary practice location

1345 Smizer Mill Rd Ste 1100
Fenton, MO 63026-7305

Mailing address

PO Box 955534
Saint Louis, MO 63195-5001

Other practice location 1

1015 Bowles Ave
Fenton, MO 63026-2394
Phone (636) 496-2000

Other identifiers 2

IdentifierTypeStateIssuer
1679546592MedicaidIL
204638019MedicaidMO

Other names 1

  • Meenu Rachel George Former name

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address rgeorge18281@direct-ehr-ssmhc.com Direct
FHIR URL https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ Other

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
I20100626000254 MO Practitioner - Internal Medicine 9234260886 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SSM Medical Group IncGroup PAC ID 6608776299, 565 clinicians

Practice addresses (Care Compare)

1035 Bellevue Ave
Suite 500
Saint Louis, MO 63117-1843
Phone (314) 925-4770

1345 Smizer Mill Rd
Fenton, MO 63026-7305

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
SSM Medical Group Inc. CurrentSince Feb 3, 2014 Accepting new patients
SSM Medical Group, Inc. Internal Medicine CurrentSince Feb 3, 2014 Accepting new patients
Inpatient Consultants of Missouri Inc Internal Medicine Past Accepting new patients
Claybrooke Medical Group, LLC Internal Medicine Past Accepting new patients
SSM Depaul Medical Group, Inc. Internal Medicine Past Accepting new patients

Locations

3221 McKelvey Rd
Ste 301
Bridgeton, MO 63044

1015 Bowles Ave
Fenton, MO 63026
Phone (636) 496-2000

1345 Smizer Mill Rd
Ste 1100
Fenton, MO 63026
Phone (636) 496-5022

1035 Bellevue Ave
Ste 500
Saint Louis, MO 63117
Phone (314) 647-1115

3555 Sunset Office Dr
Ste C100
Saint Louis, MO 63127
Phone (314) 238-9100

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

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": "1139529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603238400000",
    "number": "1679546592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 955534",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631955001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1345 SMIZER MILL RD STE 1100",
            "city": "FENTON",
            "state": "MO",
            "postal_code": "630267305",
            "telephone_number": "636-496-5022"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1015 Bowles Ave",
            "address_purpose": "LOCATION",
            "city": "Fenton",
            "state": "MO",
            "postal_code": "630262394",
            "country_code": "US",
            "telephone_number": "636-496-2000",
            "fax_number": "314-317-0606",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GEORGE",
        "first_name": "RACHEL",
        "middle_name": "MEENU",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-10",
        "last_updated": "2020-10-21",
        "certification_date": "2020-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "108366",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "MO",
            "license": "108366",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1679546592",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "204638019",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rgeorge18281@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "rgeorge18281@direct-ehr-ssmhc.com",
            "address_1": "1345 Smizer Mill Rd Ste 1100",
            "city": "Fenton",
            "state": "MO",
            "country_code": "US",
            "postal_code": "630267305",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "1345 Smizer Mill Rd Ste 1100",
            "city": "Fenton",
            "state": "MO",
            "country_code": "US",
            "postal_code": "630267305",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MEENU",
            "last_name": "GEORGE",
            "middle_name": "RACHEL",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fenton, MO

Sources for this page

Verify at the official NPI Registry.