Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Impact Physician Group, Missouri, LLC

Organization Internal Medicine Physician · NPI 1962971531

Impact Physician Group, Missouri, LLC is an Internal Medicine Physician in Bridgeton, Missouri. Works from 3 locations. Registered with an NPI since 2018.

In the registry since
2018
Specialties on file
4
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

12380 De Paul Dr
Bridgeton, MO 63044-2511
Phone: (314) 447-9700
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 1027 Bellevue Ave, Saint Louis, MO 63117-1996 — (314) 768-5202
  • 3015 N Ballas Rd, Saint Louis, MO 63131-2329 — (314) 996-6500

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X
Endocrinology, Diabetes & Metabolism Physician Taxonomy 207RE0101X
Gastroenterology Physician Taxonomy 207RG0100X
Pulmonary Disease Physician Taxonomy 207RP1001X

Record details

NPI number1962971531
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Paul Miller — Ceo · (678) 967-5599
NPI enumeratedNovember 13, 2018
Last updated in NPPESDecember 19, 2022
Certification dateDecember 19, 2022
Mailing address21 Eastbrook Bnd Ste 218, Peachtree City, GA 30269-1546

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