Individual provider Active NPI

Christy M Bauer Fogarty, MD

  • Emergency Medicine Physician
  • Saint Louis, MO
National Provider Identifier
1952383473
Registry record updated Dec 31, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MDR315 Issued in MO
Practice address
366 Conway Gardens Court
St Louis, MO 63141
Phone
(314) 996-5225
Fax
(314) 275-4005
NPI assigned
Nov 18, 2005
Last updated
Dec 31, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MDR315 MO Primary

Addresses

Primary practice location

366 Conway Gardens Court
St Louis, MO 63141

Mailing address

366 Conway Gardens CT
St Louis, MO 63141
Phone (314) 275-7746

Other identifiers 1

IdentifierTypeStateIssuer
206719031MedicaidMO

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
I20050826000609 MO Practitioner - Emergency Medicine 5890726046 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Southern Illinois University School of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Physicians of St Lukes LLCGroup PAC ID 3779714142, 63 clinicians

Practice addresses (Care Compare)

233 Clarkson Rd
Ellisville, MO 63011-2219
Phone (636) 256-8644

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MDR315MOMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy East Ambulatory Services LLC CurrentSince Sep 15, 2018 Accepting new patients
Emergency Physicians of St. Luke's, LLC Emergency Medicine CurrentSince Mar 1, 2014 Accepting new patients
Mercy Hospitals East Communities Emergency Medicine CurrentSince Jan 6, 2014 Accepting new patients
Mercy Hospitals East Communities CurrentSince Jan 6, 2014 Accepting new patients
Inphynet Contracting Services LLC Emergency Medicine Past Accepting new patients
Mercy Clinic Joplin LLC Past Accepting new patients
Midwest Emergency Associates de Paul LLC Emergency Medicine Past Accepting new patients
Sjmgroup Past Accepting new patients
SSM Health Care St. Louis Emergency Medicine Past Accepting new patients
SSM Health Care St. Louis Past Accepting new patients
Mercy Hospital South Emergency Medicine Past Accepting new patients

Locations

233 Clarkson Rd
Ellisville, MO 63011
Phone (636) 256-8644

409 Lafayette Ctr
Manchester, MO 63011
Phone (636) 707-0764

10010 Kennerly Rd
Saint Louis, MO 63128
Phone (314) 525-1328

615 S New Ballas Rd
Saint Louis, MO 63141
Phone (314) 251-4687

232 S Woods Mill Rd
Town and Country, MO 63017
Phone (314) 205-6030

901 Patients First Dr
Ste 1200
Washington, MO 63090
Phone (636) 390-1777

Organizations & group practices 11

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": "1132272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451520000000",
    "number": "1952383473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "366 CONWAY GARDENS CT",
            "city": "ST LOUIS",
            "state": "MO",
            "postal_code": "63141",
            "telephone_number": "314-275-7746",
            "fax_number": "314-275-4005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "366 CONWAY GARDENS COURT",
            "city": "ST LOUIS",
            "state": "MO",
            "postal_code": "63141",
            "telephone_number": "314-996-5225",
            "fax_number": "314-275-4005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUER FOGARTY",
        "first_name": "CHRISTY",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-18",
        "last_updated": "2015-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MO",
            "license": "MDR315",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "206719031",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.