Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Modern Medical Group Inc

Organization Foot & Ankle Surgery Podiatrist · NPI 1811752900

Modern Medical Group Inc is a Foot & Ankle Surgery Podiatrist in Saint Louis, Missouri. Registered with an NPI since 2024.

In the registry since
2024
Specialties on file
3
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

5139 Mattis Rd Ste 102
Saint Louis, MO 63128-2250
Phone: (314) 396-9517
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Multi-Specialty Clinic/Center (primary) Taxonomy 261QM1300X
Foot & Ankle Surgery Podiatrist Taxonomy 213ES0103X
Podiatric Clinic/Center Taxonomy 261QP1100X

Record details

NPI number1811752900
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jesse Wolfe — Owner · (314) 396-9517
NPI enumeratedFebruary 16, 2024
Last updated in NPPESJanuary 31, 2025
Certification dateJanuary 31, 2025
Mailing address5139 Mattis Rd Ste 102, Saint Louis, MO 63128-2250

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