1. Home
  2. Directory
  3. Missouri
  4. Bridgeton
  5. Durable Medical Equipment Medical Supplies
  6. NPI Profile

SSM HEALTH MEDICAL GROUP
NPI 1053616110
Durable Medical Equipment & Medical Supplies in Bridgeton, MO

Active since January 21, 2011CLIA Certified · 2 labs
12349 DE PAUL DR, SUITE 100, BRIDGETON, MO 63044(314) 291-3399(314) 291-3466 Get Directions Write a Review

NPPES record last updated: August 18, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Aug 18, 2020, Oct 19, 2018, Jul 18, 2018 and 1 more (4 updates tracked since 2016).

About Ssm Health Medical Group NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SSM HEALTH MEDICAL GROUP (NPI 1053616110) is a healthcare organization registered as a durable medical equipment & medical supplies in Bridgeton, Missouri and active in the NPI registry since January 2011. The organization holds 2 active CLIA laboratory certificates and lists Karen Rewerts, Vp Financial Operations, as its authorized official.

NPPES Registry Identity

NPI1053616110
Entity TypeOrganization
Primary Taxonomy332B00000X
Legal Business NameSSM MEDICAL GROUP INC.
Location Address12349 DE PAUL DR, SUITE 100Bridgeton, MO 63044
Mailing Address3221 Mckelvey Rd Ste 301Bridgeton, MO 63044-2551 · (636) 498-5944 · Fax (314) 209-8127
Phone(314) 291-3399
Fax(314) 291-3466
Organization SubpartYes
Authorized OfficialKaren RewertsVp Financial Operations · (314) 989-2034
Enumeration DateJanuary 21, 2011
Last NPPES UpdateAugust 18, 20204 updates tracked since enumeration
NPPES CertifiedAugust 18, 2020
✔ NPI 1053616110 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDurable Medical Equipment & Medical SuppliesSuppliers
Taxonomy Code332B00000X
Definition
A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.
Also ListedOrthopaedic SurgeryTaxonomy 207X00000X
12349 DE PAUL DR, Bridgeton, MO 63044
Open in Google Maps ↗

Other Names 1

Doing Business AsSsm Health Medical Group

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA 2

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Accreditation 26D2117071

Ssm Health Medical Group - Ssm Cancer Care Depaul · Bridgeton, MO
Active · expires Sep 24, 2027
CLIA Number26D2117071
Laboratory TypePhysician Office
Certificate Effective DateSeptember 25, 2025
Certificate Expiration DateSeptember 24, 2027
Laboratory DirectorGetinet D. Ayalew
Laboratory Phone(314) 209-5142
Laboratory LocationSsm Health Medical Group - Ssm Cancer Care Depaul12277 Depaul Dr Ste 100, Bridgeton, MO 63044
CLIA data matches this NPI record on: Name
This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

Certificate of Waiver 26D2267276

Ssm Health Medical Group Executive Health North · Bridgeton, MO
Active · expires Aug 22, 2026
CLIA Number26D2267276
Laboratory TypePhysician Office
Certificate Effective DateAugust 23, 2024
Certificate Expiration DateAugust 22, 2026
Laboratory DirectorAndrea A. Baxter
Laboratory Phone(314) 209-5122
Laboratory LocationSsm Health Medical Group Executive Health North12255 Depaul Drive, Suite 100, Bridgeton, MO 63044
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BRANDON CHARLES MOSELEY
Physical Therapist
12349 DE PAUL DR
BRIDGETON, MO 63044
St. Louis County (314) 209-7700
COURTNEY C GRODIE PA
Physician Assistant
12349 DE PAUL DR
BRIDGETON, MO 63044
St. Louis County (314) 291-7900
MEGAN HUGHES MCSHANE
Physical Therapist
12349 DE PAUL DR
BRIDGETON, MO 63044
St. Louis County (513) 460-0306

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ssm Medical Group Inc.'s NPI number?

The NPI number for Ssm Medical Group Inc. is 1053616110. It was assigned to this organization in the NPPES registry on January 21, 2011. The provider is doing business as Ssm Health Medical Group.

Where is Ssm Medical Group Inc. located?

Ssm Medical Group Inc. is located at 12349 De Paul Dr Suite 100, Bridgeton, MO 63044. The listed phone number is (314) 291-3399.

What is Ssm Medical Group Inc.'s specialty?

The primary specialty registered for this NPI is Durable Medical Equipment & Medical Supplies with taxonomy code 332B00000X.

Does Ssm Medical Group Inc. hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Ssm Medical Group Inc. was last updated on August 18, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.