Impact Physician Group, Missouri, LLC
NPI 1962971531 · Internal Medicine Physician · Bridgeton, MO
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Impact Physician Group, Missouri, LLC is a Internal Medicine Physician organization in Bridgeton, MO (NPI 1962971531).
Provider details
- NPI number
- 1962971531
- Entity type
- Organization
- Primary specialty
- Internal Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Paul Miller, Ceo(678) 967-5599
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
- Gastroenterology Physician207RG0100X
Allopathic & Osteopathic Physicians
- Pulmonary Disease Physician207RP1001X
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
7 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
3 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Additional practice locations (2)
- 3015 N Ballas RdSaint Louis, MO 63131-2329Phone: (314) 996-6500
- 1027 Bellevue AveSaint Louis, MO 63117-1996Phone: (314) 768-5202
Registry dates
- Enumerated
- 2018-11-13
- Last updated
- 2022-12-19
- Certified
- 2022-12-19
Frequently asked questions
- What is Impact Physician Group, Missouri, LLC's NPI number?
- Impact Physician Group, Missouri, LLC's National Provider Identifier (NPI) is 1962971531, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Impact Physician Group, Missouri, LLC?
- Impact Physician Group, Missouri, LLC is classified in the NPPES registry as Internal Medicine Physician (Allopathic & Osteopathic Physicians).
- Where is Impact Physician Group, Missouri, LLC located?
- Impact Physician Group, Missouri, LLC's practice location on file with NPPES is 12380 De Paul Dr, Bridgeton, MO 63044-2511.
- What is Impact Physician Group, Missouri, LLC's phone number?
- The practice phone number listed in the NPPES registry for Impact Physician Group, Missouri, LLC is (314) 447-9700.
- Does Impact Physician Group, Missouri, LLC accept Medicare?
- Impact Physician Group, Missouri, LLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Impact Physician Group, Missouri, LLC?
- The authorized official listed on Impact Physician Group, Missouri, LLC's NPPES record is Paul Miller, Ceo. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Impact Physician Group, Missouri, LLC's NPI active?
- Yes — Impact Physician Group, Missouri, LLC's NPI (1962971531) is active in the NPPES registry as of the last update on 2022-12-19.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.