NPIMap

Organization Active NPI

St. Anthony's Physician Organization

Doing business as Mercy Clinic South Physicians

  • Psychiatry Physician
  • Saint Louis, MO
National Provider Identifier
1992127492
Registry record updated Jan 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
ST. ANTHONY'S PHYSICIAN ORGANIZATION
Doing business as
Mercy Clinic South Physicians
Practice address
10020 Kennerly Rd FL 2
Saint Louis, MO 63128-2106
Phone
(314) 525-4429
Fax
(314) 525-7260
NPI assigned
Jan 17, 2014
Last updated
Jan 4, 2019By the provider in NPPES
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
Psychiatry Physician 2084P0800X NU Primary

Addresses

Primary practice location

10020 Kennerly Rd FL 2
Saint Louis, MO 63128-2106

Mailing address

10020 Kennerly Rd FL 2
Saint Louis, MO 63128-2106
Phone (314) 525-4429

Other identifiers 1

IdentifierTypeStateIssuer
000015644OtherMOMEDICARE PTAN

Other names 1

  • Mercy Clinic South Physicians Doing business as

National Provider Directory

National Provider Directory

Locations

10020 Kennerly Rd
Fl 2
Saint Louis, MO 63128
Phone (314) 525-4429

NPI Registry JSON

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

{
    "created_epoch": "1389916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1546560000000",
    "number": "1992127492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10020 KENNERLY RD FL 2",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282106",
            "telephone_number": "314-525-4429",
            "fax_number": "314-525-7260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10020 KENNERLY RD FL 2",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282106",
            "telephone_number": "314-525-4429",
            "fax_number": "314-525-7260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. ANTHONY'S PHYSICIAN ORGANIZATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-17",
        "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": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "000015644",
            "state": "MO"
        }
    ],
    "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.