ST. GERARD OBSTETRICS AND GYNECOLOGY, LLC (NPI# 1043305428) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043305428 |
| Entity Type | Organization |
| Organization Name | ST. GERARD OBSTETRICS AND GYNECOLOGY, LLC |
| Practice Address |
10004 Kennerly Road Suite 386b St. Louis MO 63128 |
| Practice Telephone | 3148427910 |
| Practice Fax Number | 3148427911 |
| Mailing Telephone | 3148427910 |
| Mailing Fax Number | 3148427911 |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MICHAEL B DIXON (OWNER) |
| Authorized Official Telephone | 3148427910 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians |
| Street Address |
10004 KENNERLY ROAD SUITE 386B |
| City | ST. LOUIS |
| State | MO |
| Zip Code | 63128 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124095831 | Aamina B Akhtar | Internal Medicine | 10004 Kennerly Road, #171b, St. Louis, MO 63128 | 2006-03-01 |
| 1871689356 | Chadwick T Caudill | Obstetrics & Gynecology | 10004 Kennerly Road, Suite 350a, St. Louis, MO 63128 | 2006-10-04 |
| 1720055452 | Infectious Diseases PC | Nurse Practitioner | 10004 Kennerly Road, #171b, St. Louis, MO 63128 | 2006-03-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235771155 | James T Fetsch Dmd LLC | Dentist | 10004 Kennerly Rd Suite 240, Saint Louis, MO 63128 | 2019-10-11 |
| 1326504655 | Nikodem Dental Holdings | Dentist | 4337 Butler Hill Rd Suite G, St Louis Mo, MO 63128 | 2019-02-12 |
| 1932678505 | Michelle Anne Arvidson | Physical Therapy Assistant | Elite Physical Therapy, 12608 Lamplighter Square Shopping Center, St. Louis, MO 63128 | 2018-11-13 |
| 1245726710 | Kristen Rider | Nurse Practitioner | 9964 Kennerly Rd Ste D, Saint Louis, MO 63128 | 2018-07-07 |
| 1306217427 | Sophia Bednarski | Dentist | 12660 Lamplighter Square Shopping Center, St. Louis, MO 63128 | 2015-10-15 |
| 1427434224 | Darcie Burrus | Counselor | 12523 Old Tesson Rd G, St Louis, MO 63128 | 2015-08-04 |
| 1710368584 | Sara Hawatmeh | Internal Medicine | 12345 W Bend Dr Ste 304, Saint Louis, MO 63128 | 2015-06-17 |
| 1871989590 | Celia Grace Montes-kolence | Speech-Language Pathologist | 12335 W Bend Drive, Saint Louis, MO 63128 | 2015-04-09 |
| 1245629302 | Marius Antonio Evans | Dentist | 9911 Kennerly Rd., Suite G, St. Louis, MO 63128 | 2015-01-13 |
| 1801230313 | Sarah Elizabeth Walsh | Emergency Medicine | 10010 Kennerly Road, Emergency Department, St. Anthony's Medical Center, St. Louis, MO 63128 | 2013-04-26 |
| Find all providers in zip 63128 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962895896 | John B Martin | Obstetrics & Gynecology | 312 N. Meramec #300, St. Louis, MO 63105 | 2015-03-17 |
| 1023370020 | Teresa Hilgers | Obstetrics & Gynecology | 615 South New Ballas, Department of Obstetrics and Gynecology, St. Louis, MO 63141 | 2012-06-14 |
| 1194083006 | Mackenzie P Purdy | Obstetrics & Gynecology | 621 S New Ballas Road Tower A, Suite #676, St. Louis, MO 63141 | 2012-04-27 |
| 1134416449 | Andrew Ryan Davis | Obstetrics & Gynecology | 615 South New Ballas Road - Ob/gyn Department, St. Louis, MO 63141 | 2011-07-07 |
| 1295963940 | St. Anthony's Physician Organization Private Practices Lc | Obstetrics & Gynecology | 2900 Lemay Ferry Road, Suite 216, St. Louis, MO 63125-3900 | 2009-07-01 |
| 1962466896 | Christine M Ladd | Obstetrics & Gynecology | 3009 North Ballas Road, Suite 366 C, St. Louis, MO 63131 | 2006-04-17 |
| 1659369965 | Aaron J Pile | Obstetrics & Gynecology | 10135 W Florissant Ave, St. Louis, MO 63136-2103 | 2005-10-11 |
| 1043836844 | Jordan A Mcmanus | Obstetrics & Gynecology | 621 South New Ballas Road, Suite 2009 B, St. Louis, MO 63141 | 2020-06-18 |
| 1801411871 | Melissa Cantave | Obstetrics & Gynecology | 4901 Forest Park Avenue, Suite 8064-37-905, St. Louis, MO 63108 | 2020-06-15 |
| 1083239008 | Shannon Elizabeth Beermann | Obstetrics & Gynecology | 4901 Forest Park Avenue, Suite 8064-37-905, St. Louis, MO 63108 | 2020-06-15 |
| Find all providers in ST. LOUIS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.