Organization
SAINT LUKES PHYSICIAN GROUP INC
Active
Parent organization
SAINT LUKES PHYSICIAN GROUP INC
Other names
Saint Lukes Primary Care at Home
Organization subpart
Yes
Provider details
NPI number
Legal business name
SAINT LUKES PHYSICIAN GROUP INC
Authorized official
JULIE MURPHY (CFO)
(816) 599-9563
Entity
Organization
Contact information
Practice address
901 E 104TH ST, MAILSTOP 3000E, KANSAS CITY, MO 64131-4517
(816) 502-7000
Mailing address
PO BOX 504938, SAINT LOUIS, MO 63150-4938
(816) 502-8782
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
261Q00000X
Clinic/Center
Primary
—
—
363L00000X
Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110403
MEDICARE PIN
KS
01
—
B940000
MEDICARE PIN
MO
01
—
G930000
MEDICARE PIN
KS
01
—
H720000
MEDICARE PIN
MO
Enumeration date
06/29/2021
Last updated
07/28/2021
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