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ST. ANTHONY'S PHYSICIAN ORGANIZATION NPI 1144623786


NPI Information

NPI: 1144623786
Provider Name: ST. ANTHONY'S PHYSICIAN ORGANIZATION

Doing Business As: MERCY CLINIC SOUTH PHYSICIANS

Classification: Obstetrics & Gynecology - 207V00000X
Entity Type: Organization

CLIA Number: 26D2027831

Address:
714 GRAVOIS RD
STE 115
FENTON, MO
ZIP 63026
Phone: (636) 717-6775
Get Directions

ST. ANTHONY'S PHYSICIAN ORGANIZATION is an obstetrics gynecology in Fenton, MO. The provider is an obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. ST. ANTHONY'S PHYSICIAN ORGANIZATION NPI is 1144623786. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Mercy Clinic South Physicians.

The provider's business location address is:

714 GRAVOIS RD
STE 115
FENTON, MO
ZIP 63026-723
Phone: (636) 717-6775
Fax: (636) 717-6755

The provider's authorized official is Cheryl Matejka .
The authorized official title is Cfo East Communities & Sfo and has the following contact phone number (314) 251-1958.

The CLIA number assigned to this NPI record is 26D2027831 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/26/2014 and was last updated on 1/4/2019.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207V00000XObstetrics & GynecologyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1000015644OTHERMISSOURIMEDICARE PTAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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