Bridgeton Geriatrics LLC
Bridgeton Geriatrics LLC is a healthcare organization registered as Family Medicine Physician in Bridgeton, MO, holding Type 2 (organization) NPI 1245652924 since 2014. The authorized official on file is David Smith, Owner.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1245652924 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Bridgeton Geriatrics LLC |
| Practice address | 12800 BOENKER LN, Bridgeton, MO, 63044 |
| Phone | 3145510338 |
| Fax | 3145510336 |
| Enumeration date | 2014-01-14 |
| Last updated in NPPES | 2014-01-14 |
Authorized official
| Name | David Smith |
|---|---|
| Title | Owner |
| Phone | 3145510338 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 207Q00000X | Family Medicine Physician | Primary | 104361 | MO |
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2083138069 | Medicaid | MO | — |
Copy-ready billing details
Provider: Bridgeton Geriatrics LLC NPI: 1245652924 Taxonomy: 207Q00000X (Family Medicine Physician) Address: 12800 BOENKER LN, Bridgeton, MO, 63044
Providers at this address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1649220104 | Andrea Ivy | Individual | Family Nurse Practitioner | Bridgeton, MO |
| 1841303310 | Khaled Hassan | Individual | Internal Medicine Physician | Bridgeton, MO |
| 1730259888 | Doctors Group , PC | Organization | Internal Medicine Physician | Bridgeton, MO |
| 1285042184 | Omega Long Term Care LLC | Organization | Assisted Living Facility | Bridgeton, MO |
| 1932628807 | Nutressa Monroe | Individual | Nurse Practitioner | Bridgeton, MO |
| 1457985178 | Yam Home Health LLC | Organization | Home Health Agency | Bridgeton, MO |
| 1568072650 | Yam Medical Center LLC | Organization | General Practice Physician | Bridgeton, MO |
| 1114594736 | Aireal Bishop | Individual | Gerontology Nurse Practitioner | Bridgeton, MO |
Verify this record
Cross-check NPI 1245652924 against the authoritative CMS record: view Bridgeton Geriatrics LLC on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
What is the NPI number for Bridgeton Geriatrics LLC?
Who is the authorized official for Bridgeton Geriatrics LLC?
Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2014-01-14.