ST. CLAIR CLINIC
NPI 1790953909
Family Medicine in Saint Clair, MO
About St. Clair Clinic NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ST. CLAIR CLINIC (NPI 1790953909) is a healthcare organization registered as a family medicine in Saint Clair, Missouri and active in the NPI registry since February 2008. The organization lists Raymond P. Davidson, President, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
Other Names 1
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
St. Clair Clinic is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by March 31, 2027
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
74Medicare enrollment records show 74 clinicians reassign Medicare billing to St. Clair Clinic, which bills Medicare for the services they deliver. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 12
Nearest to this location (20)
See all 74Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Missouri Baptist Hospital Of Sullivan's NPI number?
The NPI number for Missouri Baptist Hospital Of Sullivan is 1790953909. It was assigned to this organization in the NPPES registry on February 11, 2008. The provider is doing business as St. Clair Clinic.
Where is Missouri Baptist Hospital Of Sullivan located?
Missouri Baptist Hospital Of Sullivan is located at 875 N Commercial Ave, Saint Clair, MO 63077. The listed phone number is (636) 629-7467.
What is Missouri Baptist Hospital Of Sullivan's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Missouri Baptist Hospital Of Sullivan enrolled in Medicare?
Yes. Missouri Baptist Hospital Of Sullivan is registered in the Medicare PECOS enrollment system.
When is Missouri Baptist Hospital Of Sullivan's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Missouri, Clinic/Group Practice) is due for revalidation by March 31, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Missouri Baptist Hospital Of Sullivan?
According to the CMS Revalidation Reassignment List (October 2026 release), 74 clinicians in 12 Medicare specialties reassign their Medicare billing to Missouri Baptist Hospital Of Sullivan. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (25), Obstetrics/Gynecology (13) and Hospitalist (10). Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Missouri Baptist Hospital Of Sullivan was last updated on February 11, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.
# St. Clair Clinic · NPI 1790953909
Family Medicine organization in Saint Clair, Missouri. Organization record, active in the CMS NPPES registry since February 11, 2008.
## Identity
- **NPI:** 1790953909 (Entity type: Organization)
- **Enumerated:** February 11, 2008
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Legal business name:** Missouri Baptist Hospital Of Sullivan
- **Organization subpart:** No
- **Authorized official:** Raymond Davidson, PRESIDENT
## Practice location
- **Address:** 875 N COMMERCIAL AVE, Saint Clair, MO 63077-1118
- **Phone:** (636) 629-7467 · **Fax:** (636) 629-7464
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** March 31, 2027 (Non-DME Part B, Missouri, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 74 clinicians in 12 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (25), Obstetrics/Gynecology (13), Hospitalist (10); [full list](https://npiprofile.com/npi/1790953909/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** February 11, 2008
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Source: [NPI Profile](https://npiprofile.com/npi/1790953909) · Data from the CMS NPPES public registry.