NPIMap

Organization Active NPI

St. Anthony'S Physician Organization

  • Internal Medicine Physician
  • Saint Louis, MO
National Provider Identifier
1962810952
Registry record updated Jan 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
106436 Issued in MO
Legal business name
ST. ANTHONY'S PHYSICIAN ORGANIZATION
Practice address
10004 Kennerly Rd
Suite 200a
Saint Louis, MO 63128-2141
Phone
(314) 842-9975
Fax
(314) 842-5535
NPI assigned
Jul 23, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2019

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

Authorized official

Name
Ms. Cheryl Matejka
Title
Cfo East Communities & Sfo
Phone
(314) 251-1958

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 106436 MO Primary

Addresses

Primary practice location

10004 Kennerly Rd
Suite 200a
Saint Louis, MO 63128-2141

Mailing address

9735 Landmark Parkway Dr
Suite 200
Saint Louis, MO 63127-1646
Phone (314) 543-6985

Other names 1

  • Mercy Clinic South Physicians Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1406073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1546560000000",
    "number": "1962810952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9735 LANDMARK PARKWAY DR",
            "address_2": "SUITE 200",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631271646",
            "telephone_number": "314-543-6985",
            "fax_number": "314-543-6836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10004 KENNERLY RD",
            "address_2": "SUITE 200A",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282141",
            "telephone_number": "314-842-9975",
            "fax_number": "314-842-5535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. ANTHONY'S PHYSICIAN ORGANIZATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-23",
        "last_updated": "2019-01-04",
        "status": "A",
        "authorized_official_last_name": "MATEJKA",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_title_or_position": "CFO EAST COMMUNITIES & SFO",
        "authorized_official_telephone_number": "314-251-1958",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "106436",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mercy Clinic South Physicians",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jan 4, 2019; 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.