NPIMap

Organization Active NPI

Signature Medical Group, Inc

  • Durable Medical Equipment & Medical Supplies
  • Chesterfield, MO
National Provider Identifier
1982473153
Registry record updated Aug 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
SIGNATURE MEDICAL GROUP, INC
Practice address
121 Saint Lukes Center Dr Ste 302
Chesterfield, MO 63017-3519
Phone
(314) 849-0311
Fax
(314) 849-4423
NPI assigned
Dec 28, 2023
Last updated
Aug 8, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2024

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

121 Saint Lukes Center Dr Ste 302
Chesterfield, MO 63017-3519

Mailing address

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240506001625 MO DME Supplier - Physician - Unknown Physician Specialty 4880598291 Practice locations: Chesterfield, MO

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Signature Medical Group 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

1390 US Highway 61
Ste G1000
Crystal Cty, MO 63028
Phone (636) 933-7400

606 Maple Valley Dr
Farmington, MO 63640
Phone (573) 756-7779

1015 Bowles Ave
Ste 100
Fenton, MO 63026

2 Progress Point Pkwy
Ste H
O Fallon, MO 63368
Phone (314) 983-4700

550 Technology Dr
Ste 205
Saint Charles, MO 63304
Phone (636) 329-0250

1027 Bellevue Ave
Ste 25
Saint Louis, MO 63117
Phone (314) 645-4600

11125 Dunn Rd
Ste 204
Saint Louis, MO 63136
Phone (314) 355-2300

12855 N 40 Dr
Ste 180
Saint Louis, MO 63141
Phone (314) 878-5599

2821 N Ballas Rd
Ste C60
Saint Louis, MO 63131
Phone (314) 872-3104

621 S New Ballas Rd
Ste 2009B
Saint Louis, MO 63141
Phone (314) 251-6062

7345 Watson Rd
#3
Saint Louis, MO 63119
Phone (314) 633-8558

965 Mattox Dr
Bldg B
Sullivan, MO 63080
Phone (314) 872-3104

Practitioners & affiliated clinicians

Practitioners 53

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 53

NPI Registry JSON

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

{
    "created_epoch": "1703721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723075200000",
    "number": "1982473153",
    "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": "121 SAINT LUKES CENTER DR STE 302",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630173519",
            "telephone_number": "314-849-0311",
            "fax_number": "314-849-4423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIGNATURE MEDICAL GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-28",
        "last_updated": "2024-08-08",
        "certification_date": "2024-08-01",
        "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"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesterfield, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.