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SSM HEALTH MEDICAL GROUP
NPI 1285741629
Internal Medicine in Troy, MO

Active since August 23, 2006CLIA Certified · 2 labs
172 PROFESSIONAL PARKWAY, TROY, MO 63379(636) 462-6106(636) 669-2401 Get Directions Write a Review

NPPES record last updated: January 15, 2016. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Ssm Health Medical Group NPPES

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

SSM HEALTH MEDICAL GROUP (NPI 1285741629) is a healthcare organization registered as an internal medicine in Troy, Missouri and active in the NPI registry since August 2006. The organization holds 2 active CLIA laboratory certificates and lists Laura Pullum, Billing Manager, as its authorized official.

NPPES Registry Identity

NPI1285741629
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameSSM ST. CHARLES CLINIC MEDICAL GROUP, INC.
Location Address172 PROFESSIONAL PARKWAYTroy, MO 63379-1520
Mailing Address1551 Wall St, Suite 310Saint Charles, MO 63303-3539 · (636) 669-2268 · Fax (314) 209-8127
Phone(636) 462-6106
Fax(636) 669-2401
Organization SubpartNo
Authorized OfficialLaura PullumBilling Manager · (636) 669-2434
Enumeration DateAugust 23, 2006
Last NPPES UpdateJanuary 15, 2016
✔ NPI 1285741629 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Also ListedFamily MedicineTaxonomy 207Q00000X
Also ListedInternal Medicine · Cardiovascular DiseaseTaxonomy 207RC0000X · License R9286 (MO)
172 PROFESSIONAL PARKWAY, Troy, MO 63379
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Other Names 1

Doing Business AsSsm Health Medical Group

Other Identifiers 2

Medicaid501887806MO
Medicare PIN000013759MO

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 for Provider-Performed Microscopy Procedures (PPMP) 26D0441352

Ssm Health Medical Group · Troy, MO
Active · expires Apr 25, 2028
CLIA Number26D0441352
Laboratory TypePhysician Office
Certificate Effective DateApril 26, 2026
Certificate Expiration DateApril 25, 2028
Laboratory DirectorStanley Sachak
Laboratory Phone(636) 462-6106
Laboratory LocationSsm Health Medical Group172 Professional Parkway, Troy, MO 63379
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Certificate of Waiver 26D2132172

Ssm St Charles Clinic Medical Group, Inc · Saint Charles, MO
Active · expires Jun 12, 2027
CLIA Number26D2132172
Laboratory TypePhysician Office
Certificate Effective DateJune 13, 2025
Certificate Expiration DateJune 12, 2027
Laboratory DirectorDaniel Kramer
Laboratory Phone(636) 669-2469
Laboratory LocationSsm St Charles Clinic Medical Group, Inc711 Veterans Memorial Parkway Suite 200, Saint Charles, MO 63303
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

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

DR. RODRIGO G GOH M.D.
Internal Medicine (Cardiovascular Disease)
172 PROFESSIONAL PARKWAY, PO BOX A
TROY, MO 63379
Lincoln County (636) 462-6106

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 St. Charles Clinic Medical Group, Inc.'s NPI number?

The NPI number for Ssm St. Charles Clinic Medical Group, Inc. is 1285741629. It was assigned to this organization in the NPPES registry on August 23, 2006. The provider is doing business as Ssm Health Medical Group.

Where is Ssm St. Charles Clinic Medical Group, Inc. located?

Ssm St. Charles Clinic Medical Group, Inc. is located at 172 Professional Parkway, Troy, MO 63379. The listed phone number is (636) 462-6106.

What is Ssm St. Charles Clinic Medical Group, Inc.'s specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Does Ssm St. Charles Clinic 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 St. Charles Clinic Medical Group, Inc. was last updated on January 15, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.