SSM Medical Group, Inc.

Organization Active NPI Multi-Specialty Clinic/Center · Fenton, MO

NPI 1700966207 · NPPES record last updated Apr 22, 2026

Key facts

NPI
1700966207
Entity type
Organization (NPI type 2)
Primary specialty
Multi-Specialty Clinic/Center 261QM1300X
Legal business name
SSM MEDICAL GROUP, INC.
Practice address
1011 Bowles Ave
Suite 300
Fenton, MO 63026-2395
Phone
(636) 496-5000
Fax
(636) 496-5045
NPI assigned
Oct 17, 2006
Organization subpart
No

Authorized official

Name
Eileen Lamb
Title
Regional VP Finance
Phone
(314) 994-6219

Other NPIs on the same Medicare enrollment 1

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

Other NPIs with the same Medicare PAC ID 7

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Practitioners 767

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 767

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in MO, IL

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20040729001034 MO Part B Supplier - Clinic/Group Practice 6608776299 Receives reassigned benefits from 742 practitioners
1 other NPI on this enrollment
O20150929002491 IL Part B Supplier - Clinic/Group Practice 6608776299 Receives reassigned benefits from 25 practitioners
1 other NPI on this enrollment
Practice locations: Shiloh, IL; Red Bud, IL; Alton, IL; O Fallon, IL; Nashville, IL; Maryville, IL; Granite City, IL; Glen Carbon, IL…

National Provider Directory

Locations

1000 Eleven S
Ste 4A
Columbia, IL 62236
Phone (618) 206-6120

12277 De Paul Dr
Ste 500
Bridgeton, MO 63044

400 Medical Plz
Ste 100
Lake St Louis, MO 63367
Phone (636) 639-8600

400 1st Capitol Dr
Ste 401
Saint Charles, MO 63301
Phone (314) 946-8700

711 Veterans Memorial Pkwy
Ste 200
Saint Charles, MO 63303
Phone (636) 379-6363

400 1st Capitol Dr
Ste 301
Saint Charles, MO 63301
Phone (314) 739-8844

1475 Kisker Rd
Ste 180
Saint Charles, MO 63304
Phone (636) 442-7300

1475 Kisker Rd
Ste 185
Saint Charles, MO 63304
Phone (636) 498-5800

300 1st Capitol Dr
Saint Charles, MO 63301
Phone (636) 669-2211

10777 Sunset Office Dr
Ste 210
Saint Louis, MO 63127

1031 Bellevue Ave
Ste 100
Saint Louis, MO 63117
Phone (314) 540-8332

5401 Veterans Memorial Pkwy
Ste 101
Saint Peters, MO 63376
Phone (636) 939-4820

164 Professional Pkwy
Troy, MO 63379
Phone (636) 462-5437

18800 Schnucks Dr
Warrenton, MO 63383
Phone (636) 456-3413

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Yes

Addresses

Primary practice location

1011 Bowles Ave
Suite 300
Fenton, MO 63026-2395

Mailing address

PO Box 955534
Saint Louis, MO 63195-5534
Phone (557) 203-0943

Other names

  • SSM Health Medical Group Doing business as

Other providers in Fenton, MO

All providers in Fenton, MO · Multi-Specialty Clinic/Center in Missouri

Sources for this page

Verify at the official NPI Registry.