Individual provider Active NPI

Catherine S Wilke, MD

  • Internal Medicine Physician
  • Saint Louis, MO
National Provider Identifier
1811958176
Registry record updated Aug 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
102564 Issued in MO
Practice address
12348 Old Tesson Rd
Suite 240
Saint Louis, MO 63128-2251
Phone
(314) 467-3900
NPI assigned
Mar 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 102564 MO Primary

Addresses

Primary practice location

12348 Old Tesson Rd
Suite 240
Saint Louis, MO 63128-2251

Mailing address

12348 Old Tesson Rd
Suite 240
Saint Louis, MO 63128-2251
Phone (314) 467-3900

Other identifiers 2

IdentifierTypeStateIssuer
1811958176MedicaidMO
110179942OtherMORAILROAD MEDICARE

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
I20070524000371 MO Practitioner - Internal Medicine 0840397923 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
102564MOMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic East Communities CurrentSince Jul 1, 2007 Accepting new patients
Mercy Clinic East Communities Internal Medicine CurrentSince Jul 1, 2007 Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

12348 Old Tesson Rd
Ste 240
Saint Louis, MO 63128
Phone 3144673900 ext. 284

621 S New Ballas Rd
Ste 189A
Saint Louis, MO 63141
Phone (314) 251-6335

621 S New Ballas Rd
Ste 4017B
Saint Louis, MO 63141
Phone (314) 872-9192

Interoperability endpoints

  • Direct secure messaging: cwilke234@directc.mercy.net

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1143504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408579200000",
    "number": "1811958176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12348 OLD TESSON RD",
            "address_2": "SUITE 240",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282251",
            "telephone_number": "314-467-3900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12348 OLD TESSON RD",
            "address_2": "SUITE 240",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282251",
            "telephone_number": "314-467-3900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKE",
        "first_name": "CATHERINE",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-28",
        "last_updated": "2014-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "102564",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1811958176",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110179942",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.