NPIMap

Organization Active NPI

Galen Inpatient Physicians, PC

  • Internal Medicine Physician
  • Fenton, MO
National Provider Identifier
1689258345
Registry record updated Jun 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
GALEN INPATIENT PHYSICIANS, PC
Practice address
1015 Bowles Ave
Fenton, MO 63026-2394
Phone
(636) 496-2000
NPI assigned
May 10, 2021
Last updated
Jun 22, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2021

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

Authorized official

Name
David Birdsall
Title
C.O.O
Phone
(510) 350-2638

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

1015 Bowles Ave
Fenton, MO 63026-2394

Mailing address

2100 Powell St Ste 400
Emeryville, CA 94608-1826
Phone (510) 350-2638

Other practice location 1

12303 De Paul Dr
Bridgeton, MO 63044-2512
Phone (314) 344-6000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191115000362 MO Part B Supplier - Clinic/Group Practice 3678464633 Receives reassigned benefits from 93 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Bridgeton, MO; Fenton, MO

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 13

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1620604800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624320000000",
    "number": "1689258345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 POWELL ST STE 400",
            "city": "EMERYVILLE",
            "state": "CA",
            "postal_code": "946081826",
            "telephone_number": "510-350-2638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 BOWLES AVE",
            "city": "FENTON",
            "state": "MO",
            "postal_code": "630262394",
            "telephone_number": "636-496-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12303 De Paul Dr",
            "address_purpose": "LOCATION",
            "city": "Bridgeton",
            "state": "MO",
            "postal_code": "630442512",
            "country_code": "US",
            "telephone_number": "314-344-6000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "GALEN INPATIENT PHYSICIANS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-10",
        "last_updated": "2021-06-22",
        "certification_date": "2021-06-22",
        "status": "A",
        "authorized_official_last_name": "BIRDSALL",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "C.O.O",
        "authorized_official_telephone_number": "510-350-2638"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fenton, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.