Individual provider Active NPI

Melissa K Stein, DO

  • Family Medicine Physician
  • Fenton, MO
National Provider Identifier
1962447599
Registry record updated Feb 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2005011422 Issued in MO
Practice address
714 Gravois Rd
Ste 100
Fenton, MO 63026-7727
Phone
(636) 326-6100
NPI assigned
Jun 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 2005011422 MO
Family Medicine Physician 207Q00000X 2005011422 MO Primary

Addresses

Primary practice location

714 Gravois Rd
Ste 100
Fenton, MO 63026-7727

Mailing address

678 Barnacle CT
Englewood, FL 34223-6561
Phone (314) 435-8831

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20071109000039 MO Practitioner - Family PracticePractitioner - Emergency Medicine 7719075779 Reassigns benefits to 1 organization
I20220504001483 FL Practitioner - Emergency Medicine 7719075779 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Freeman-Oak Hill Health System CurrentSince Feb 19, 2021 Accepting new patients
Em Alliance LLC Emergency Medicine CurrentSince Aug 1, 2023 Accepting new patients
Freeman-Oak Hill Health System Family Medicine CurrentSince Feb 19, 2021 Accepting new patients
Mercy Hospital South Emergency Medicine Past Accepting new patients

Locations

206 2nd St E
Bradenton, FL 34208
Phone (941) 745-7202

10101 Forest Hill Blvd
West Palm Beach, FL 33414
Phone (561) 766-1301

1102 W 32nd St
Joplin, MO 64804
Phone (417) 347-1078

1130 E 32nd St
Joplin, MO 64804
Phone (417) 347-2273

1636 S Madison St
Webb City, MO 64870
Phone (417) 347-2273

7 Easton Oval
#L4387
Columbus, OH 43219

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1150588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613433600000",
    "number": "1962447599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "678 BARNACLE CT",
            "city": "ENGLEWOOD",
            "state": "FL",
            "postal_code": "342236561",
            "telephone_number": "314-435-8831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "714 GRAVOIS RD",
            "address_2": "STE 100",
            "city": "FENTON",
            "state": "MO",
            "postal_code": "630267727",
            "telephone_number": "636-326-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEIN",
        "first_name": "MELISSA",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-18",
        "last_updated": "2021-02-16",
        "certification_date": "2021-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MO",
            "license": "2005011422",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2005011422",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fenton, MO

Sources for this page

Verify at the official NPI Registry.