| Mark A.scheperle, Inc. | |
|
1520 S Brentwood Blvd Saint Louis MO 63144-1407 | |
| (314) 862-7711 | |
| (314) 862-7879 |
| Full Name | Mark A.scheperle, Inc. |
|---|---|
| Speciality | Internal Medicine |
| Location | 1520 S Brentwood Blvd, Saint Louis, Missouri |
| Authorized Official Name and Position | Mark A Scheperle (DELEGATED OFFICIAL) |
| Authorized Official Contact | 3148627711 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mark A.scheperle, Inc. 1520 S Brentwood Blvd Saint Louis MO 63144-1407 Ph: (314) 862-7711 | Mark A.scheperle, Inc. 1520 S Brentwood Blvd Saint Louis MO 63144-1407 Ph: (314) 862-7711 |
| NPI Number | 1063484434 |
|---|---|
| Provider Enumeration Date | 02/01/2006 |
| Last Update Date | 07/02/2024 |
| Medicare PECOS PAC ID | 0749269850 |
|---|---|
| Medicare Enrollment ID | O20040714000284 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063484434 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 101625 (Missouri) | Secondary |
| 207R00000X | Internal Medicine | F22892 (Missouri) | Primary |
| Provider Name | Gregorio C Tambone |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962487744 PECOS PAC ID: 1153300272 Enrollment ID: I20040714000327 |
| Provider Name | Mark A Scheperle |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1265417034 PECOS PAC ID: 0244238020 Enrollment ID: I20061110000383 |
| Provider Name | Mary Elizabeth Orris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194966572 PECOS PAC ID: 6901942101 Enrollment ID: I20091001000085 |
| Provider Name | Anna B Hummel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447580030 PECOS PAC ID: 7719012640 Enrollment ID: I20100317000955 |
| Provider Name | Jennifer A Berry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366719072 PECOS PAC ID: 5496918195 Enrollment ID: I20120516000401 |
| Provider Name | Meghan A Sullivan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740694074 PECOS PAC ID: 6103044995 Enrollment ID: I20140819002494 |
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