SSM HEALTH MEDICAL GROUP – NPI #1073880480
Internal Medicine

An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.

SSM HEALTH MEDICAL GROUP is a provider located in LOUISIANA, MO. NPPES has assigned the NPI number 1073880480 to SSM HEALTH MEDICAL GROUP on November 30, 2011. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “SSM HEALTH MEDICAL GROUP” is a dba name, the actual legal business name for this organization is SSM DEPAUL MEDICAL GROUP, INC.. The primary taxonomy selected by this provider is 207RC0000X from the Health Care Provider Taxonomy code set, which is classified as Internal Medicine, specializing in Cardiovascular Disease

The NPI profile was previously updated about 10 years ago on Jan 15, 2016. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for SSM HEALTH MEDICAL GROUP below.

NPI Profile for
SSM DEPAUL MEDICAL GROUP, INC.

NPI Number
1073880480
Enumeration Date

(more than 14 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
SSM DEPAUL MEDICAL GROUP, INC.
Doing Business As (dba): SSM HEALTH MEDICAL GROUP
Primary location
2305 GEORGIA ST
LOUISIANA, MO 63353-2559
Phone: (314) 291-0846 Fax: (573) 754-6056
Mailing address
1551 WALL ST
SUITE 310
SAINT CHARLES, MO 63303-3539
Phone: (636) 669-2268 Fax: (314) 209-8127
Organization Subpart
No
Authorized Official
LAURA PULLUM
BILLING MANAGER
Phone: (636) 669-2434
Updated
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207RC0000X
- Internal Medicine / Cardiovascular Disease (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.