SSM Health St. Mary's Hospital - Centralia – General Acute Care Hospital, NPI 1083617245

SSM Health St. Mary's Hospital - Centralia is a healthcare provider. based in Saint louis, Missouri. specializing in General Acute Care Hospital. The organization holds a License No. 0002642 (IL). The NPI Number for SSM Health St. Mary's Hospital - Centralia is 1083617245

Main info

Organization
Name
SSM Health St. Mary's Hospital - Centralia
NPI
1083617245
Phone
(314) 989-3524
Address
1195 CORPORATE LAKE DR
Authorized Official
MR. DAMON R HARBISON PRESIDENT
Enumeration Date
23 May 2005
Last Update Date
27 November 2023

Contacts

Main Contact
https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience59
Completeness90
Years active:21State licenses:1Updated within 12 months

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Provider Addresses for SSM Health St. Mary's Hospital - Centralia

  • Corporate Lake Drive, 39 North, Creve Coeur, Saint Louis County, Missouri, 63132, United States of America

    SAINT LOUIS, MO 631321716

    Phone: (314) 989-3524

    Fax: (314) 989-3695

    Type: Mailing

  • Saint Mary's Hospital, 400, North Pleasant Avenue, Centralia, Marion County, Illinois, 62801, United States of America

    CENTRALIA, IL 62801

    Phone: (618) 436-8000

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2007-11-10

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20071110000096OHospitalILTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 63132)

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Reviews

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Frequently asked questions

What is SSM Health St. Mary's Hospital - Centralia's NPI number?
SSM Health St. Mary's Hospital - Centralia's NPI is 1083617245 — the number used across U.S. healthcare to identify this provider.
Would SSM Health St. Mary's Hospital - Centralia appear as active to a payer?
You can treat SSM Health St. Mary's Hospital - Centralia as active for directory purposes; confirm clinical privileges separately.
How would a patient describe SSM Health St. Mary's Hospital - Centralia's focus?
For SSM Health St. Mary's Hospital - Centralia, the primary taxonomy reads as General Acute Care Hospital. Clinical services aligned with this taxonomy classification.
What practice footprint exists for SSM Health St. Mary's Hospital - Centralia?
Travel planning: use Saint Louis, Missouri as the reference point for SSM Health St. Mary's Hospital - Centralia, then confirm.
Can I trust this NPI listing for SSM Health St. Mary's Hospital - Centralia?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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