Active NPI
GM Health LLC
- Internal Medicine Physician
- Saint Louis, MO
National Provider Identifier
1831886175
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- Legal business name
- GM HEALTH LLC
- Practice address
- 11040 Sandistan Dr
Saint Louis, MO 63146-5583 - Phone
- (402) 208-2254
- NPI assigned
- Apr 18, 2023
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. George Mansour, MD
- Title
- Owner
- Phone
- (402) 208-2254
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | Primary |
Addresses
Primary practice location
11040 Sandistan Dr
Saint Louis, MO 63146-5583
Mailing address
11040 Sandistan Dr
Saint Louis, MO 63146-5583
Phone (402) 208-2254
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20230712002076 | MO | Part B Supplier - Clinic/Group Practice | 2567822307 |
Receives reassigned benefits from 3 practitioners Practice locations: Saint Louis, MO |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 3
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1681776000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1681776000000",
"number": "1831886175",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11040 SANDISTAN DR",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631465583",
"telephone_number": "402-208-2254"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11040 SANDISTAN DR",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631465583",
"telephone_number": "402-208-2254"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GM HEALTH LLC",
"organizational_subpart": "NO",
"enumeration_date": "2023-04-18",
"last_updated": "2023-04-18",
"certification_date": "2023-04-18",
"status": "A",
"authorized_official_last_name": "MANSOUR",
"authorized_official_first_name": "GEORGE",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "402-208-2254",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2023; 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.