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
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
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

1895 Richardson Rd
Arnold, MO 63010
Phone (314) 756-2800

1765 Old State Route 21
Arnold, MO 63010
Phone (636) 296-4466

1165 N Butterfield Rd
Bolivar, MO 65613
Phone (417) 777-6246

1015 Bowles Ave
Ste 100
Fenton, MO 63026

1011 Bowles Ave
Ste 100
Fenton, MO 63026

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

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

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

10012 Kennerly Rd
Ste 405
Saint Louis, MO 63128
Phone (314) 378-9864

12122 Tesson Ferry Rd
Ste 101
Saint Louis, MO 63128
Phone (314) 842-0602

633 Emerson Rd
Ste 50
Saint Louis, MO 63141
Phone (314) 645-4600

10004 Kennerly Rd
Ste 335A
Saint Louis, MO 63128
Phone (314) 525-1497

12122 Tesson Ferry Rd
Ste 100
Saint Louis, MO 63128
Phone (314) 821-4884

Practitioners & affiliated clinicians

Practitioners 55

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

View all 55

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.