Organization Active NPI

St. Luke's Family Medicine - Maryland Heights LLC

  • Internal Medicine Physician
  • Maryland Heights, MO
National Provider Identifier
1902197767
Registry record updated Mar 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
ST. LUKE'S FAMILY MEDICINE - MARYLAND HEIGHTS LLC
Practice address
915 Fee Fee Rd
Maryland Heights, MO 63043-3801
Phone
(314) 770-1777
Fax
(314) 590-5952
NPI assigned
Apr 28, 2011
Last updated
Mar 5, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
ST. LUKES MEDICAL GROUPAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 5, 2026

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

Authorized official

Name
Mr. Darren Haskell, MD.NPI 1689636813
Title
Chief Medical Officer
Phone
(314) 205-6444

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

915 Fee Fee Rd
Maryland Heights, MO 63043-3801

Mailing address

915 Fee Fee Rd
Maryland Heights, MO 63043-3801
Phone (314) 770-1777

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110608000289 MO Part B Supplier - Clinic/Group Practice 5597942193 Receives reassigned benefits from 1 practitioner
Practice locations: Maryland Heights, MO

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
26D2308993St Luke's Family Medicine - Maryland Heights915 Fee Fee Road, Maryland Heights, MO 63043Certificate of waiverAug 6, 2026

National Provider Directory

National Provider Directory
Part of
St Lukes Medical Group

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

915 Fee Fee Rd
Ste 100
Maryland Heights, MO 63043

915 Fee Fee Rd
Maryland Hts, MO 63043
Phone (314) 770-1777

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1303948800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1772668800000",
    "number": "1902197767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 FEE FEE RD",
            "city": "MARYLAND HEIGHTS",
            "state": "MO",
            "postal_code": "630433801",
            "telephone_number": "314-770-1777",
            "fax_number": "314-770-1776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 FEE FEE RD",
            "city": "MARYLAND HEIGHTS",
            "state": "MO",
            "postal_code": "630433801",
            "telephone_number": "314-770-1777",
            "fax_number": "314-590-5952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. LUKE'S FAMILY MEDICINE - MARYLAND HEIGHTS LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ST. LUKES MEDICAL GROUP",
        "enumeration_date": "2011-04-28",
        "last_updated": "2026-03-05",
        "certification_date": "2026-03-05",
        "status": "A",
        "authorized_official_last_name": "HASKELL",
        "authorized_official_first_name": "DARREN",
        "authorized_official_title_or_position": "CHIEF MEDICAL OFFICER",
        "authorized_official_telephone_number": "314-205-6444",
        "authorized_official_name_prefix": "Mr.",
        "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 Maryland Heights, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.