Active NPI
David Glick, M.D.
- Family Medicine Physician
- Saint Louis, MO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 112861
- Practice address
- 175 N Oaks PLZ
Saint Louis, MO 63121-2925 - Phone
- (314) 391-9777
- Fax
- (314) 390-5404
- NPI assigned
- Nov 30, 2005
- Last updated
- Oct 21, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 112861 | MO | Primary |
Addresses
Primary practice location
175 N Oaks PLZ
Saint Louis, MO 63121-2925
Mailing address
1395 NW 167TH St
Miami Gardens, FL 33169-5710
Phone (314) 391-9777
Other practice location 1
401 Holly Hills Ave
Saint Louis, MO 63111-2410
Phone (314) 353-5190
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 204977102 | Medicaid | MO | |
| 047010581 | Other | MO | CPIN |
| 20497110 | Medicaid | MO |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Saint Louis University School of Medicine, 1997
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1780 Old Hwy 50 E
Suite 102
Union, MO 63084-3397
Phone (888) 403-1071
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Compass Health, Inc | Current | Accepting new patients | |
| Compass Health, Inc | Current | Accepting new patients | |
| Ozarks Medical Center | Family Medicine | Past | Accepting new patients |
Locations
1800 Community
Clinton, MO 64735
Phone (660) 885-8131
1800 Community
#B
Clinton, MO 64735
102 Compass Point Dr
Saint Charles, MO 63301
Phone (636) 332-8318
3785 New Town Blvd
Saint Charles, MO 63301
Phone (636) 669-2332
8075 Mexico Rd
Saint Peters, MO 63376
Phone (573) 234-5258
101 Progress Pkwy
Sullivan, MO 63080
Phone (573) 468-3555
91 Troy Sq
Troy, MO 63379
1780 Old Highway 50 E
Ste 102
Union, MO 63084
Phone (636) 583-1611
19515 Brune Pkwy
Warrenton, MO 63383
Phone (636) 235-4049
1032 Crosswinds Ct
Wentzville, MO 63385
Phone (636) 332-6000
Organizations & group practices 3
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.
-
dba Compass Health Network
- Community/Behavioral Health Agency
- Clinton, MO
- NPI 1285619494
-
- Federally Qualified Health Center (FQHC)
- Rolla, MO
- NPI 1558258632
-
dba Ozarks Healthcare
- General Acute Care Hospital
- West Plains, MO
- NPI 1831115641
Family Medicine
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Mercy Hospital Washington
- General Acute Care Hospital
- Washington, MO
- NPI 1285664177
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1133308800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1634774400000",
"number": "1679557177",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1395 NW 167TH ST",
"city": "MIAMI GARDENS",
"state": "FL",
"postal_code": "331695710",
"telephone_number": "314-391-9777",
"fax_number": "314-390-5404"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "175 N OAKS PLZ",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631212925",
"telephone_number": "314-391-9777",
"fax_number": "314-390-5404"
}
],
"practiceLocations": [
{
"address_1": "401 Holly Hills Ave",
"address_purpose": "LOCATION",
"city": "Saint Louis",
"state": "MO",
"postal_code": "631112410",
"country_code": "US",
"telephone_number": "314-353-5190",
"fax_number": "314-353-1310",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GLICK",
"first_name": "DAVID",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-30",
"last_updated": "2021-10-21",
"certification_date": "2021-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MO",
"license": "112861",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "204977102",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CPIN",
"identifier": "047010581",
"state": "MO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "20497110",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.