SIGNATURE MEDICAL GROUP INC NPI 1871542761

NPI Information

  • NPI: 1871542761
  • Provider Name: SIGNATURE MEDICAL GROUP, INC
  • Classification: Orthopaedic Surgery - 207X00000X
  • Entity Type: Organization
  • Address: 12639 OLD TESSON RD
    SUITE 115
    SAINT LOUIS, MO
    ZIP 63128
  • Phone: (314) 849-0311

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NPI Details

SIGNATURE MEDICAL GROUP, INC is an orthopaedic surgery in Saint Louis, MO. The provider is an orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. SIGNATURE MEDICAL GROUP, INC NPI is 1871542761. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

12639 OLD TESSON RD
SUITE 115
SAINT LOUIS, MO
ZIP 63128-786
Phone: (314) 849-0311
Fax: (314) 849-4423

The provider's authorized official is Chad Sackman .
The authorized official title is Ceo and has the following contact phone number (314) 849-0311.

The enumeration date for this NPI number is 5/8/2006 and was last updated on 8/8/2024.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207KA0200XAllergy & ImmunologyAllergyNo
2207N00000XDermatologyMISSOURINo
3207RG0100XInternal MedicineGastroenterologyMISSOURINo
4207T00000XNeurological SurgeryMISSOURINo
5207V00000XObstetrics & GynecologyNo
6207VX0201XObstetrics & GynecologyGynecologic OncologyMISSOURINo
7207X00000XOrthopaedic SurgeryYes
8208000000XPediatricsMISSOURINo
92081P2900XPhysical Medicine & RehabilitationPain MedicineNo
10208600000XSurgeryMISSOURINo
11208C00000XColon & Rectal SurgeryMISSOURINo

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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1501357701MEDICAIDMISSOURI
2377225OTHERMISSOURIHEALTHLINK
33223OTHERMISSOURIGROUP HEALTH PLAN
47217344OTHERMISSOURIAETNA
5CY0091OTHERMISSOURIRAILROAD MEDICARE

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: 3/30/2025

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