| Simply Health Integrated Medical Llc | |
|
12977 N 40 Dr Ste 105 Saint Louis MO 63141-8654 | |
| (630) 590-4686 | |
| (636) 206-8361 |
| Full Name | Simply Health Integrated Medical Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 12977 N 40 Dr Ste 105, Saint Louis, Missouri |
| Authorized Official Name and Position | Bryan Deloney (OWNER) |
| Authorized Official Contact | 6365904686 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Simply Health Integrated Medical Llc 126 Hilltown Village Ctr Chesterfield MO 63017-0709 Ph: (630) 590-4686 | Simply Health Integrated Medical Llc 12977 N 40 Dr Ste 105 Saint Louis MO 63141-8654 Ph: (630) 590-4686 |
| NPI Number | 1679175988 |
|---|---|
| Provider Enumeration Date | 11/11/2020 |
| Last Update Date | 12/12/2024 |
| Medicare PECOS PAC ID | 7810309796 |
|---|---|
| Medicare Enrollment ID | O20201217001600 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679175988 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 332B00000X | Durable Medical Equipment & Medical Supplies | (* (Not Available)) | Secondary |
| Provider Name | Kristine G Gonzalez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750791331 PECOS PAC ID: 5597989384 Enrollment ID: I20140618000335 |
| Provider Name | Elizabeth Ann Shipp |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033659859 PECOS PAC ID: 1355628074 Enrollment ID: I20170508000726 |
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