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

Keith Wickenhauser, MD

Individual provider Internal Medicine Physician · NPI 1184042855

Keith Wickenhauser, MD is an Internal Medicine in Saint Charles, Missouri. Graduated from Saint Louis University School of Medicine in 2014, 12 years ago. Practices with SSM Medical Group Inc, a 560-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in Kentucky and Missouri.

Years since qualifying
12
Trained at
Saint Louis University School of Medicine
Licensed in
KY, MO
In the registry since
2014
Specialties on file
3
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

711 Veterans Memorial Pkwy Ste 300
Saint Charles, MO 63303-2106
Phone: (636) 669-2350
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 550 S Jackson St, Louisville, KY 40202 — (502) 852-4277

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence 2018011071 (MO)
Internal Medicine Physician Taxonomy 207R00000X · Licence R3656 (KY)
Pediatrics Physician Taxonomy 208000000X · Licence 2018011071 (MO)

Record details

NPI number1184042855
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMarch 31, 2014
Last updated in NPPESSeptember 3, 2024
Certification dateSeptember 3, 2024
Mailing addressPo Box 955534, Saint Louis, MO 63195-5534

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyINTERNAL MEDICINE
Also practisesPEDIATRIC MEDICINE
Medical schoolSAINT LOUIS UNIVERSITY SCHOOL OF MEDICINE
Graduated 2014 (12 years in practice)
Group practice Ssm Medical Group Inc — 560 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

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