Individual provider Active NPI

George Vieweg Thieroff III, MD

  • Pediatric Rheumatology Physician
  • Saint Louis, MO
National Provider Identifier
1912352931
Registry record updated Oct 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Rheumatology PhysicianTaxonomy code 2080P0216X
License
2025040384 Issued in MO
Practice address
1465 S Grand Blvd
Saint Louis, MO 63104-1003
Phone
(314) 633-7365
NPI assigned
Apr 27, 2016
Last updated
Oct 6, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2025040384 MO
Rheumatology Physician 207RR0500X 2025040384 MO
Pediatric Rheumatology Physician 2080P0216X 2025040384 MO Primary

Addresses

Primary practice location

1465 S Grand Blvd
Saint Louis, MO 63104-1003

Mailing address

1101 E Marshall St # 980663
Richmond, VA 23298-5008
Phone (804) 828-9357

Other practice location 1

1250 E Marshall St
Box 980163
Richmond, VA 23298-5051
Phone (804) 828-9357

Other practice location 2

1201 S Grand Blvd
Saint Louis, MO 63104-1016
Phone (314) 633-7365

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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 1

Enrollment IDStateProvider typePAC IDDetails
I20251006001018 MO Practitioner - Pediatric Medicine 2466746979 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SSM Health Care GroupGroup PAC ID 0143608372, 929 clinicians

Practice addresses (Care Compare)

1465 S Grand Blvd
Saint Louis, MO 63104-1003
Phone (314) 577-5641

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2025040384MOMDPediatric Rheumatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
SSM Health Care Group Internal Medicine CurrentSince Sep 16, 2025 Accepting new patients
SSM Health Care Group CurrentSince Sep 16, 2025 Accepting new patients
SSM Medical Group Inc. Past Accepting new patients

Locations

10101 Woodfield Ln
Saint Louis, MO 63132
Phone (608) 280-4647

1201 S Grand Blvd
Saint Louis, MO 63104
Phone (314) 257-1320

1465 S Grand Blvd
Saint Louis, MO 63104
Phone (314) 268-4070

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1461715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759708800000",
    "number": "1912352931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 E MARSHALL ST # 980663",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232985008",
            "telephone_number": "804-828-9357",
            "fax_number": "804-828-8660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1465 S GRAND BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631041003",
            "telephone_number": "314-633-7365"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1250 E Marshall St",
            "address_2": "Box 980163",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "VA",
            "postal_code": "232985051",
            "country_code": "US",
            "telephone_number": "804-828-9357",
            "fax_number": "804-828-5466",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1201 S Grand Blvd",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631041016",
            "country_code": "US",
            "telephone_number": "314-633-7365",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THIEROFF",
        "first_name": "GEORGE",
        "middle_name": "VIEWEG",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-27",
        "last_updated": "2025-10-06",
        "certification_date": "2025-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2025040384",
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "MO",
            "license": "2025040384",
            "primary": false
        },
        {
            "code": "2080P0216X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Rheumatology",
            "state": "MO",
            "license": "2025040384",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.