Individual provider Active NPI

Gerald S Lowther, MD

  • Pediatrics Physician
  • Grover, MO
National Provider Identifier
1922075027
Registry record updated Feb 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
27157 Issued in MO
Practice address
16555 Manchester Rd
Suite 201
Grover, MO 63040-1220
Phone
(636) 458-5858
NPI assigned
Mar 7, 2006
Last updated
Feb 15, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 27157 MO Primary

Addresses

Primary practice location

16555 Manchester Rd
Suite 201
Grover, MO 63040-1220

Mailing address

16555 Manchester Rd
Suite 201
Grover, MO 63040-1220
Phone (636) 458-5858

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
I20130715000280 MO Practitioner - Pediatric Medicine 4981844081 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
27157MOMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic East Communities CurrentSince Apr 1, 2013 Accepting new patients
Mercy Clinic East Communities Pediatrics CurrentSince Apr 1, 2013 Accepting new patients
Mercy Hospitals East Communities Past Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

621 S New Ballas Rd
Ste 189A
Saint Louis, MO 63141
Phone (314) 251-6335

621 S New Ballas Rd
Ste 4017B
Saint Louis, MO 63141
Phone (314) 872-9192

16555 Manchester Rd
Ste 201
Wildwood, MO 63040
Phone (636) 458-0040

Interoperability endpoints

  • Direct secure messaging: glowther1092@directc.mercy.net

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1141689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329264000000",
    "number": "1922075027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16555 MANCHESTER RD",
            "address_2": "SUITE 201",
            "city": "GROVER",
            "state": "MO",
            "postal_code": "630401220",
            "telephone_number": "636-458-5858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16555 MANCHESTER RD",
            "address_2": "SUITE 201",
            "city": "GROVER",
            "state": "MO",
            "postal_code": "630401220",
            "telephone_number": "636-458-5858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOWTHER",
        "first_name": "GERALD",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-07",
        "last_updated": "2012-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "27157",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grover, MO

Sources for this page

Verify at the official NPI Registry.