MEDICARE: MID-COUNTY PHYSICIANS, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	101YA0400X	Addiction (Substance Use Disorder) Counselor
2	101YM0800X	Mental Health Counselor
3	101YP2500X	Professional Counselor
4	103TB0200X	Cognitive & Behavioral Psychologist
5	103TC0700X	Clinical Psychologist
6	103TC1900X	Counseling Psychologist
7	103TC2200X	Clinical Child & Adolescent Psychologist
8	103TF0000X	Family Psychologist
9	103T00000X	Psychologist
10	2084A0401X	Addiction Medicine (Psychiatry & Neurology) Physician
11	2084P0800X	Psychiatry Physician
12	2084P0802X	Addiction Psychiatry Physician
13	2084P0804X	Child & Adolescent Psychiatry Physician
14	2084P0805X	Geriatric Psychiatry Physician
15	1041C0700X	Clinical Social Worker

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	CP9113	OTHER	MO	RR MEDICARE GROUP ID

General Provider Information

NPI Number	:	1184764904
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MID-COUNTY PHYSICIANS, INC.

Provider Business Mailing Address
First Line	:	12166 OLD BIG BEND RD
Second Line	:	SUITE 100
City	:	KIRKWOOD
State	:	MO
Zip	:	63122-6844
Country	:	US
Telephone Number	:	314-909-0211
Fax Number	:	314-909-0323

Provider Business Practice Location Address
First Line	:	12166 OLD BIG BEND RD
Second Line	:	SUITE 100
City	:	KIRKWOOD
State	:	MO
Zip	:	63122-6844
Country	:	US
Telephone Number	:	314-909-0211
Fax Number	:	314-909-0323

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DAVID L OHLMS
Credential	:	M.D.
Telephone Number	:	314-909-0211

Provider Enumeration Date	:	02/08/2007
Last Update Date	:	09/11/2025

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1588659288 — DR. DAVID LEE OHLMS M.D.
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KIRKWOOD, MO
63122-6844

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Practice Fax: 314-909-0323

1437140159 — MRS. TERRI R. OHLMS M.S.W., L.C.S.W.
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12166 OLD BIG BEND RD , SUITE 100
KIRKWOOD, MO
63122-6844

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Practice Location Address:

12166 OLD BIG BEND RD , SUITE 100
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63122-6844

Practice Phone: 314-909-0211
Practice Fax: 314-909-0323

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