Individual provider Active NPI

Gene M Labarge, M.D.

  • Pediatrics Physician
  • St. Louis, MO
National Provider Identifier
1740294149
Registry record updated Sep 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
2006017164 Issued in MO
Practice address
1465 S Grand Blvd
St. Louis, MO 63104-1003
Phone
(314) 268-4101
Fax
(314) 577-5379
NPI assigned
Jul 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 2006017164 MO Primary

Addresses

Primary practice location

1465 S Grand Blvd
St. Louis, MO 63104-1003

Mailing address

3691 Rutger Ave
St. Louis, MO 63110-2515
Phone (314) 977-6828

Other identifiers 1

IdentifierTypeStateIssuer
206286403MedicaidMO

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
I20070612000172 MO Practitioner - Pediatric Medicine 9234237488 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2006017164MOMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
SSM Health Care Group CurrentSince Jul 1, 2022 Accepting new patients
SSM Cardinal Glennon Childrens Hospital Pediatrics CurrentSince Jan 1, 2016 Accepting new patients
SSM Cardinal Glennon Children'S Hospital Pediatrics CurrentSince Jan 1, 2016 Accepting new patients
SSM Health Care Group Pediatrics CurrentSince Jul 1, 2022 Accepting new patients
SSM Health Care St. Louis Past Accepting new patients
SSM Cardinal Glennon Children'S Hospital Past Accepting new patients

Locations

7344 Solutions Ctr
Chicago, IL 60677
Phone (314) 989-6189

3691 Rutger St
Saint Louis, MO 63110
Phone (314) 268-4101

1465 S Grand Blvd
Saint Louis, MO 63104
Phone (314) 268-4070

10101 Woodfield Ln
Saint Louis, MO 63132
Phone (608) 280-4647

Interoperability endpoints

  • Direct secure messaging: glabarge9723@direct-ehr-ssmhc.com

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442361600000",
    "number": "1740294149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3691 RUTGER AVE",
            "city": "ST. LOUIS",
            "state": "MO",
            "postal_code": "631102515",
            "telephone_number": "314-977-6828",
            "fax_number": "314-977-6872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1465 S GRAND BLVD",
            "city": "ST. LOUIS",
            "state": "MO",
            "postal_code": "631041003",
            "telephone_number": "314-268-4101",
            "fax_number": "314-577-5379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LABARGE",
        "first_name": "GENE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-28",
        "last_updated": "2015-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "2006017164",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "206286403",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St. Louis, MO

Sources for this page

Verify at the official NPI Registry.