George P. Stachecki, M.D.
Individual provider Active NPI Family Medicine Physician · O'Fallon, MO
NPI 1902916927 · NPPES record last updated Aug 17, 2021
Key facts
- NPI
- 1902916927
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 2003015153 (MO)
- Practice address
- 2630 State Highway K
Ste 100
O'Fallon, MO 63368 - Phone
- (636) 240-5454
- NPI assigned
- Aug 30, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Inpatient Consultants of Missouri Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 2003015153 | MO | Yes |
Addresses
Primary practice location
2630 State Highway K
Ste 100
O'Fallon, MO 63368
Mailing address
2630 State Highway K
Ste 100
O'Fallon, MO 63368
Phone (636) 240-5454
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 208826107 | Medicaid | MO |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ | Health Information Exchange (HIE) |
Other providers in O'Fallon, MO
- Beverly Dawn Schneider
- Laura Michelle Sibley
- Lillie L Smith
- Spectrum Monitoring, LLC
- St Lukes Center for Diagnostic Imaging LLC
- Dipali D Thakker
- Total Access Urgent Care, PC
- Maryann L Udy
- Shirley Joyce Vandiver
- Vital Chiropractic LLC
All providers in O'Fallon, MO · Family Medicine Physician in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 17, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.