# SSM HEALTH CARE ST. LOUIS

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- **Entity:** Organization
- **Status:** Active
- **Other names:** SSM Health St. Joseph Hospital - Lake Saint Louis Physician Billing
- **Organization subpart:** No

## Provider details

- **NPI number:** 1538113097
- **Authorized official:** KAREN REWERTS (VP FINANCE)
- **Authorized official phone:** (636) 625-5200

## Contact information

- **Practice address:** 100 MEDICAL PLZ, LAKE ST LOUIS, MO 63367-1366
- **Practice address phone:** (636) 625-5200
- **Practice address fax:** (636) 625-5314
- **Mailing address:** 10176 CORPORATE SQUARE DR STE 100B, ATTNT: CREDENTIALING DEPT., SAINT LOUIS, MO 63132-2924
- **Mailing address phone:** (314) 989-2615
- **Mailing address fax:** (314) 810-1399

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207PE0004X | Emergency Medical Services (Emergency Medicine) Physician | — | NULL | Yes |
| 207PE0004X | Emergency Medical Services (Emergency Medicine) Physician | — | — | Yes |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 207RC0000X | Cardiovascular Disease Physician | — | NULL | — |
| 207RC0000X | Cardiovascular Disease Physician | — | — | — |
| 207RC0200X | Critical Care Medicine (Internal Medicine) Physician | — | NULL | — |
| 207RC0200X | Critical Care Medicine (Internal Medicine) Physician | — | — | — |
| 207RP1001X | Pulmonary Disease Physician | — | NULL | — |
| 207RP1001X | Pulmonary Disease Physician | — | — | — |
| 207T00000X | Neurological Surgery Physician | — | NULL | — |
| 207T00000X | Neurological Surgery Physician | — | — | — |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | — |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | — |
| 208000000X | Pediatrics Physician | — | NULL | — |
| 208000000X | Pediatrics Physician | — | — | — |
| 2080N0001X | Neonatal-Perinatal Medicine Physician | — | NULL | — |
| 2080N0001X | Neonatal-Perinatal Medicine Physician | — | — | — |
| 2086S0129X | Vascular Surgery Physician | — | NULL | — |
| 2086S0129X | Vascular Surgery Physician | — | — | — |

## Other

- **Enumeration date:** 05/20/2006
- **Last updated:** 06/02/2026