NPIMap

Organization Active NPI

Signature Health Services

  • Magnetic Resonance Imaging (MRI) Clinic/Center
  • Saint Louis, MO
National Provider Identifier
1962432492
Registry record updated Oct 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Magnetic Resonance Imaging (MRI) Clinic/CenterTaxonomy code 261QM1200X
Legal business name
SIGNATURE HEALTH SERVICES
Practice address
12639 Old Tesson Road
Suite 125
Saint Louis, MO 63128-2786
Phone
(314) 849-0311
Fax
(314) 849-4423
NPI assigned
Jul 3, 2006
Reactivated
Jun 13, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2025

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

Authorized official

Name
Mr. Chad Sackman
Title
Ceo
Phone
(314) 849-0311

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Magnetic Resonance Imaging (MRI) Clinic/Center 261QM1200X Primary
Radiology Clinic/Center 261QR0200X

Addresses

Primary practice location

12639 Old Tesson Road
Suite 125
Saint Louis, MO 63128-2786

Mailing address

12639 Old Tesson Rd Ste 115
Saint Louis, MO 63128-2786
Phone (314) 849-0311

Other identifiers 6

IdentifierTypeStateIssuer
711357707MedicaidMO
1601036OtherMOUNITED HEALTHCARE
194369OtherMOBLUE CROSS BLUE SHIELD
81493OtherMOGROUP HEALTHPLAN
0725114OtherMOCIGNA
620955OtherMOHEALTHLINK

National Provider Directory

National Provider Directory
Tax ID family
Premier Care Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

226 S Woods Mill Rd
Ste 62W
Chesterfield, MO 63017
Phone (314) 469-3990

845 N New Ballas Ct
Ste 30
Saint Louis, MO 63141

12639 Old Tesson Rd
Saint Louis, MO 63128
Phone (314) 446-0291

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761609600000",
    "number": "1962432492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12639 OLD TESSON RD STE 115",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282786",
            "telephone_number": "314-849-0311",
            "fax_number": "314-849-4423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12639 OLD TESSON ROAD",
            "address_2": "SUITE 125",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282786",
            "telephone_number": "314-849-0311",
            "fax_number": "314-849-4423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIGNATURE HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-03",
        "last_updated": "2025-10-28",
        "certification_date": "2025-10-28",
        "deactivation_date": "2024-04-12",
        "reactivation_date": "2024-06-13",
        "status": "A",
        "authorized_official_last_name": "SACKMAN",
        "authorized_official_first_name": "CHAD",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "314-849-0311",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Magnetic Resonance Imaging (MRI)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "711357707",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "1601036",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "194369",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP HEALTHPLAN",
            "identifier": "81493",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "0725114",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "620955",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.