ANDREA R. SAMPLE MD – NPI #1972602761
Obstetrics & Gynecology

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.

Health Care Provider Taxonomy Code for Obstetrics & Gynecology

ANDREA SAMPLE is a physician located in BRIDGETON, MO. NPPES has assigned the NPI number 1972602761 to ANDREA SAMPLE on September 21, 2006. It is a Type-1 NPI, indicating this NPI number is associated with an individual. She is also known by her former name ANDREA R JEFFERSON. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 207V00000X from the Health Care Provider Taxonomy code set, which is classified as Obstetrics & Gynecology.

The NPI profile was previously updated about 6 years ago on Oct 26, 2020. 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 ANDREA SAMPLE below.

NPI Profile for
ANDREA R. SAMPLE

NPI Number
1972602761
Enumeration Date

(more than 19 years ago)
Entity Type
Type-1  Individual (Female)
Legal Name
ANDREA R. SAMPLE
Former Name: ANDREA R JEFFERSON
Credentials
MD
Primary location
12277 DE PAUL DR STE 305
BRIDGETON, MO 63044-2529
Phone: (314) 344-7585 Fax:
1 Other location(s):
493 Saint Francois St
Suite 2
Florissant, MO 63031-5043
Phone: (314) 972-9888
Fax: (314) 972-9880
Mailing address
PO BOX 955534
SAINT LOUIS, MO 63195-5534
Phone: Fax:
Sole Proprietor
No
Updated
Certification Date
Oct 26, 2020

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Identifiers

Identifiers for ANDREA SAMPLE

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
OTHERMISSOUIR LICENSEMO2006012211
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
207V00000X
- Obstetrics & Gynecology (Primary)		 MO 2006012211
174400000X
- Specialist		 MO 2006012211

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.

Endpoint

Health Information Exchange (HEI)

HEI is the mobilization of health care information electronically across organizations within a region, community or hospital system. Endpoints provide a simple and secure way for participants to send authenticated, encrypted health information directly to known, trusted recipients over the internet such as primary care physicians, specialists, hospitals, labs, etc.

View All Endpoint(s)
Endpoint
[email protected]
Endpoint type
Direct Messaging Address
Endpoint Description
Content Type
OTHER
Affiliation
N
Endpoint Location
12277 DE PAUL DR STE 305,
BRIDGETON, MO 77025-1669
Endpoint
https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/
Endpoint type
FHIR URL
Endpoint Description
Content Type
OTHER
Affiliation
N
Endpoint Location
12277 DE PAUL DR STE 305,
BRIDGETON, MO 77025-1669

Additional Information

Education
UNIVERSITY OF MISSOURI, KANSAS CITY, SCHOOL OF MEDICINE - Graduated 2002
Accepts Medicare
This provider accepts Medicare-approved amount as payment in full. The Medicare-approved amount is the total the provider can be paid. When a provider accepts the Medicare-approved amount as payment, you won't be billed for more than the Medicare deductible & coinsureance.
Medicare Ordering & Referring
Provider can:
  • Refer to Part B
  • Order Durable Medical Equipment
  • Refer to Home Health Agency
  • Order Power Mobility Devices
Affiliations
ANDREA SAMPLE is affiliated with the following medical group(s):
  • HOSPITAL
    • SSM HEALTH DEPAUL HOSPITAL ST LOUIS
      12303 DEPAUL DRIVE
      BRIDGETON, MO 63044

Why is my NPI data (personal information) being displayed publicly?
If you have an active NPI profile, your profile is required to be disclosed according to the FOIA and eFOIA. HIPAA also requires covered providers to share their NPI with other providers, health plans, clearinghouses and any entity that may need it for billing purposes.

How do I correct or change the NPI data displayed here?
At any time, providers can make changes to their NPI profile at NPPES. Login to NPPES to make changes online or call (800) 465-3203 for assistance. Changes made at NPPES will be reflected on this web site within a few days.

Can I hide my NPI profile from the public?
Unfortunately, No. The NPPES discloses health care provider data under the Freedom of Information Act to the public, which means anyone may request such information directly from the National Plan & Provider Enumeration System. See the complete CMS Data Dissemination Notice here.