Organization
SSM REGIONAL HEALTH SERVICES
Active
Parent organization
SSM REGIONAL HEALTH SERVICES
Other names
SSM Health Medical Group - Family Medicine
Organization subpart
Yes
Provider details
NPI number
Legal business name
SSM REGIONAL HEALTH SERVICES
Authorized official
SHASTA RENE MANUEL (REGIONAL VICE PRESIDENT-FINANCE/CFO)
(405) 272-7282
Entity
Organization
Contact information
Practice address
140 NORTHSTAR DR, HOLTS SUMMIT, MO 65043-1123
(573) 896-8301
(573) 896-8589
Mailing address
7655 SOLUTIONS CTR, CHICAGO, IL 60677-7006
(557) 203-1551
(314) 989-6721
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
502624307
—
MO
Enumeration date
05/26/2006
Last updated
12/16/2025
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