FAMILY MEDICINE AT DEPAUL
NPI 1003929407
Family Medicine in Bridgeton, MO

NPI Status: Active since August 17, 2006

Contact Information

12255 DE PAUL DR
SUITE 200
BRIDGETON, MO
ZIP 63044
Phone: (314) 344-7600
Fax: (314) 344-7850

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  • Organization
  • Family Medicine
  • CLIA Number: 26D0699299
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 08-18-2026

About FAMILY MEDICINE AT DEPAUL

This page provides the complete NPI Profile along with additional information for Family Medicine At Depaul, a primary care provider established in Bridgeton, Missouri operating as a Family Medicine. The healthcare provider is registered in the NPI registry with number 1003929407 assigned on August 2006. The practitioner's primary taxonomy code is 207Q00000X. The provider is registered as an organization and their NPI record was last updated 6 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The provider's is doing business as Family Medicine At Depaul. The authorized official of this NPI record is Ms. Laura Lynn Pullum (Director Of Patient Accounts)

NPI
1003929407
Provider Legal Name
SSM DEPAUL MEDICAL GROUP, INC.
Other Organization Name
FAMILY MEDICINE AT DEPAUL
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
12255 DE PAUL DR SUITE 200 BRIDGETON, MO 63044
Location Phone
(314) 344-7600
Location Fax
(314) 344-7850
Mailing Address
12255 DE PAUL DR SUITE 200 BRIDGETON, MO 63044
Mailing Phone
(314) 344-7600
Mailing Fax
(314) 344-7850
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
08-17-2006
Last Update Date
08-22-2020
Code Navigator

A primary care provider (PCP) like Family Medicine At Depaul sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Family Medicine

Taxonomy Code
207Q00000X
Type
Allopathic & Osteopathic Physicians
Taxonomy Description
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Group Taxonomy 193400000X SINGLE SPECIALTY GROUP

This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MS. LAURA LYNN PULLUM

Authorized Official Title
DIRECTOR OF PATIENT ACCOUNTS
Authorized Official Phone
(314) 209-8121

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
26D0699299
Facility Type
Physician Office
Certificate Effective Date
August 19, 2024
Certificate Expiration Date
August 18, 2026
Laboratory Director
NAVEED RAZZAQUE
Certificate Type
Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description
This CLIA certificate is issued to Family Medicine At Depaul in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1003929407, we treat the final digit (7) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 53. The final step is to find the difference between that total and the next multiple of ten (60 - 53 = 7).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
0
Unchanged
Pos 3
0
Doubled → 0
Pos 4
3
Unchanged
Pos 5
9
Doubled → 18 → 1 + 8
Pos 6
2
Unchanged
Pos 7
9
Doubled → 18 → 1 + 8
Pos 8
4
Unchanged
Pos 9
0
Doubled → 0
Check
7
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 0 → 0 9 → 18 → 9 9 → 18 → 9 0 → 0

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 0 + 0 + 3 + 1 + 8 + 2 + 1 + 8 + 4 + 0 + 24 = 53

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 53 is 60. The difference is the calculated check digit.

60 - 53 = 7
This NPI is valid
The calculated check digit is 7, which matches the last digit of 1003929407.

Other Providers at the Same Location


The following 19 providers are registered at the same or a nearby location.

Podiatrist (Foot & Ankle Surgery)
12255 DE PAUL DR, SUITE 470
BRIDGETON, MO 63044
Obstetrics & Gynecology
12255 DE PAUL DR, STE 765
BRIDGETON, MO 63044
Internal Medicine
12255 DE PAUL DR, SUITE 550
BRIDGETON, MO 63044
Family Medicine
12255 DE PAUL DR, SUITE 200
BRIDGETON, MO 63044
Family Medicine
12255 DE PAUL DR, SUITE 600
BRIDGETON, MO 63044
Dermatology
12255 DE PAUL DR, #845
BRIDGETON, MO 63044
Pediatrics
12255 DE PAUL DR, SUITE 490
BRIDGETON, MO 63044
Pediatrics
12255 DE PAUL DR, SUITE 490
BRIDGETON, MO 63044
Surgery (Surgery of the Hand)
12255 DE PAUL DR, SUITE 165
BRIDGETON, MO 63044
Ophthalmology
12255 DE PAUL DR, SUITE 420
BRIDGETON, MO 63044
Ophthalmology
12255 DE PAUL DR, SUITE 360
BRIDGETON, MO 63044
Podiatrist (Foot & Ankle Surgery)
12255 DE PAUL DR, STE 100
BRIDGETON, MO 63044
Podiatrist (Foot & Ankle Surgery)
12255 DE PAUL DR, STE 470
BRIDGETON, MO 63044
Neurological Surgery
12255 DE PAUL DR, SUITE 830
BRIDGETON, MO 63044
Technician/Technologist (Optician)
12255 DE PAUL DR
BRIDGETON, MO 63044
Podiatrist
12255 DE PAUL DR, STE. 470
BRIDGETON, MO 63044
Obstetrics & Gynecology
12255 DE PAUL DR, STE 765
BRIDGETON, MO 63044
Dermatology
12255 DE PAUL DR, 845
BRIDGETON, MO 63044
Thoracic Surgery (Cardiothoracic Vascular Surgery)
12255 DE PAUL DR, SUITE 445
BRIDGETON, MO 63044

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1003929407, enumerated as an "organization" on August 17, 2006.

The provider is located at 12255 DE PAUL DR SUITE 200 BRIDGETON, MO 63044 and the phone number is (314) 344-7600.

Family Medicine with taxonomy code 207Q00000X.