Individual provider Active NPI

Stephen James Smith, D.O.

  • Emergency Medicine Physician
  • Saint Louis, MO
National Provider Identifier
1851771265
Registry record updated Sep 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
2022026079 Issued in MO
Practice address
915 N Grand Blvd
Saint Louis, MO 63106-1621
Phone
(314) 289-6410
NPI assigned
Jun 2, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 1642 NE
Emergency Medicine Physician 207P00000X 2022026079 MO Primary

Addresses

Primary practice location

915 N Grand Blvd
Saint Louis, MO 63106-1621

Mailing address

7828 Wakeley PLZ
Omaha, NE 68114-3650
Phone (402) 315-2987

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE, TN, MO3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20170824001432 NE Practitioner - Family Practice 2466769203 Reassigns benefits to 2 organizations
I20201209003175 TN Practitioner - Family Practice 2466769203 Reassigns benefits to 1 organization
I20221123000907 MO Practitioner - Emergency Medicine 2466769203 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2022026079MOMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Avera St Anthonys Hospital CurrentSince Sep 25, 2018 Accepting new patients
Southeast Missouri Hospital Physicians, LLC Family Medicine CurrentSince Jun 12, 2024 Accepting new patients
Southeastern Emergency Physicians of Memphis LLC Emergency Medicine CurrentSince Oct 1, 2022 Accepting new patients
Avera St Anthonys Hospital CurrentSince Sep 25, 2018 Accepting new patients
Emergency Medical Care Facilities PC Emergency Medicine CurrentSince Jan 15, 2021 Accepting new patients
Avera St Anthonys Hospital Current Accepting new patients
Alegent Creighton Clinic Family Medicine Past Accepting new patients

Locations

1600 E Broadway
Columbia, MO 65201
Phone (573) 632-5000

1701 Lacey St
Cpe Girardeau, MO 63701
Phone (573) 334-4822

915 N Grand Blvd
Saint Louis, MO 63106
Phone (314) 289-6434

300 N 2nd St
Oneill, NE 68763
Phone (402) 336-2900

620 Skyline Dr
Jackson, TN 38301
Phone (731) 541-4923

Organizations & group practices 7

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": "1433203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757376000000",
    "number": "1851771265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7828 WAKELEY PLZ",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681143650",
            "telephone_number": "402-315-2987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 N GRAND BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631061621",
            "telephone_number": "314-289-6410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "STEPHEN",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-02",
        "last_updated": "2025-09-09",
        "certification_date": "2025-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NE",
            "license": "1642",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MO",
            "license": "2022026079",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.