Saint Medical Group, LLC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

Legal business name

SAINT MEDICAL GROUP, LLC

Doing business as

SSM Health Medical Group On Demand

Practice address

30 Ronnies PLZ
Sappington, MO 63126-3552

Phone

(314) 989-6807

Fax

(314) 989-6608

NPI assigned

Apr 8, 2021

Last updated

Apr 8, 2021By the provider in NPPES

Organization subpart

Yes

Parent organization

SSM HEALTH CARE OF OKLAHOMA, INC.As reported in NPPES

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

Authorized official

Name

Crystal L Pena

Title

Provider Coordinator

Phone

(405) 272-7452

Specialties & licenses 4

Addresses

Other names 1

• SSM Health Medical Group On Demand Doing business as

Tax ID family

Saint Medical Group LLC114 organizations share this tax ID, including this one

Part of

Sah Op CLN

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

{
    "created_epoch": "1617840000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617840000000",
    "number": "1851971550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 RONNIES PLZ",
            "city": "SAPPINGTON",
            "state": "MO",
            "postal_code": "631263552",
            "telephone_number": "314-989-6807",
            "fax_number": "314-989-6608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 RONNIES PLZ",
            "city": "SAPPINGTON",
            "state": "MO",
            "postal_code": "631263552",
            "telephone_number": "314-989-6807",
            "fax_number": "314-989-6608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAINT MEDICAL GROUP, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SSM HEALTH CARE OF OKLAHOMA, INC.",
        "enumeration_date": "2021-04-08",
        "last_updated": "2021-04-08",
        "certification_date": "2021-04-08",
        "status": "A",
        "authorized_official_last_name": "PENA",
        "authorized_official_first_name": "CRYSTAL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PROVIDER COORDINATOR",
        "authorized_official_telephone_number": "405-272-7452"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SSM Health Medical Group On Demand",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• JPRX Inc
• JPRX Inc (Medicine Shoppe 0832 LTC)
• Gabriela Mendoza
• Mercy Pharmacy Services LLC
• Grace Milford
• Jordan Sweet, FNP-C
• Taylor Paul Chiropractic LLC (Performance Health and Wellness)
• Jennifer Vandas, COTA

• Nurse Practitioner in Sappington, MO
• Providers in Sappington, MO by specialty
• Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.