Individual provider Active NPI

Mary Ellen Fox, MD

  • Family Medicine Physician
  • Saint Louis, MO
National Provider Identifier
1710957287
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
R1H07 Issued in MO
Practice address
414 Spring Ave
Saint Louis, MO 63119-2635
Phone
(314) 558-4111
Fax
(314) 558-4111
NPI assigned
Jan 25, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X R1H07 MO Primary

Addresses

Primary practice location

414 Spring Ave
Saint Louis, MO 63119-2635

Mailing address

414 Spring Ave
Saint Louis, MO 63119-2635
Phone (314) 558-4111

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
I20041013000190 MO Practitioner - Family PracticePractitioner - Hospice/Palliative Care 1658331897 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Hospice/Palliative Care
Education
University of Missouri, Columbia School of Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2029 Woodland Pkwy
Suite 105
Saint Louis, MO 63146-4267
Phone (314) 918-7171

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Visiting Nurse Association of Greater St. Louis CurrentSince Apr 1, 2016 Accepting new patients
Jesse D Helton Family Medicine Past Accepting new patients
Mercy Hospital South Past Accepting new patients

Locations

2029 Woodland Pkwy
Ste 105
Saint Louis, MO 63146
Phone (314) 918-7171

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1138147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1710957287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "414 SPRING AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631192635",
            "telephone_number": "314-558-4111",
            "fax_number": "314-558-4111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "414 SPRING AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631192635",
            "telephone_number": "314-558-4111",
            "fax_number": "314-558-4111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOX",
        "first_name": "MARY",
        "middle_name": "ELLEN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-01-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "R1H07",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.