ST LOUIS SPINE AND JOINT PAIN SPECIALISTS LLC (NPI# 1043762974) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043762974 |
| Entity Type | Organization |
| Organization Name | ST LOUIS SPINE AND JOINT PAIN SPECIALISTS LLC |
| Practice Address |
520 Center Street Fenton MO 63026-4246 |
| Mailing Address |
520 Center Street Fenton MO 63026 |
| Practice Telephone | 3145163289 |
| Mailing Telephone | 3145163289 |
| Enumeration Date | 2016-10-26 |
| Last Update Date | 2020-01-15 |
| Authorized Official Name | ADAM SHOMSTEIN (CHIEF OFFICER) |
| Authorized Official Telephone | 3145163289 |
| Authorized Official Credential | DO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2081P2900X |
Physical Medicine & Rehabilitation Specialization: Pain Medicine |
2016035827 | MO | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1365 Nykiel Ct, Ballwin, MO 630114246 | 7042222010 |
| Street Address |
520 CENTER STREET |
| City | FENTON |
| State | MO |
| Zip Code | 63026-4246 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871000372 | Allison Egler | Audiologist | 1011 Bowles Ave Ste 405, Fenton, MO 63026 | 2018-01-05 |
| 1629508213 | Holly Brooks Munson | Massage Therapist | 220 Copper Mountain Dr, Fenton, MO 63026 | 2017-06-15 |
| 1073978862 | Naomi Sharon | Nurse Practitioner | 1101 Bowles Avenue, Suite G50, Fenton, MO 63026 | 2015-12-21 |
| 1871981704 | Celtic Private Care of Il & Mo, LLC | In Home Supportive Care | 1653 Larkin Williams Road, Suite 201, Fenton, MO 63026 | 2014-12-30 |
| 1356747513 | Kristina Potts | Nurse Practitioner | 774 Gravois Bluffs Blvd Ste B, Fenton, MO 63026 | 2014-11-14 |
| 1245642420 | Physicians Health Group Medical Inc | General Practice | 960 S. Highway Dr, Fenton, MO 63026 | 2014-05-22 |
| 1598047409 | Kevin Eugene Bruce | Pharmacist | 1210 Sugar Creek, Fenton, MO 63026 | 2011-09-16 |
| 1215186382 | Concentra Health Services, Inc. | Clinic/Center | 128 Matrix Commons Dr., Fenton, MO 63026 | 2008-09-15 |
| 1790954410 | Castlewood Treatment Center LLC | Community/Behavioral Health | 1855 Bowles Ave, Suite 210, Fenton, MO 63026 | 2008-02-27 |
| 1073703617 | Christina R Baeres | Dietitian, Registered | 38 Majestic Ct, Fenton, MO 63026 | 2007-07-30 |
| Find all providers in zip 63026 | ||||
| Taxonomy Code | 2081P2900X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Physical Medicine & Rehabilitation |
| Specialization | Pain Medicine |
| A physician who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic or cancer pain in both hospital and ambulatory settings. Patient care needs may also be coordinated with other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source changed] Additional Resources: American Board of Physical Medicine and Rehabilitation, 2007. http://www.abpmr.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Physical Medicine and Rehabilitation. A subspecialty certificate was approved by the ABMS in 1999. ACGME Accredited Residency Program Requirements: Proposal under development. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043879471 | P.r.i.m.e. Health Centers - Chesterfield, LLC | Physical Medicine & Rehabilitation | 253 Chesterfield Industrial Blvd, Chesterfield, MO 63005-1201 | 2019-06-10 |
| 1396300505 | Russell Thurman | Physical Medicine & Rehabilitation | 305 Thornbrooke Dr, Rogersville, MO 65742-8737 | 2019-05-02 |
| 1841753209 | Ap Medical | Physical Medicine & Rehabilitation | 1131 W Main St Ste A, Blue Springs, MO 64015-3698 | 2019-04-11 |
| 1043774821 | Riley Stowe | Physical Medicine & Rehabilitation | 1301 Tullison Rd, Kansas City, MO 64116-2640 | 2019-01-26 |
| 1477843985 | Diana Mekler | Physical Medicine & Rehabilitation | 1365 Nykiel Ct, Ballwin, MO 63011-4246 | 2011-04-18 |
| 1962707075 | Charles Mauldin, Md PC | Physical Medicine & Rehabilitation | 3003 E Chestnut Expy Ste 109, Springfield, MO 65802-2527 | 2011-01-20 |
| 1730364647 | Gary D Eaton | Physical Medicine & Rehabilitation | 3705 Bethel St, Columbia, MO 65203-5603 | 2008-01-09 |
| 1619081890 | Nehal P Modh | Physical Medicine & Rehabilitation | 1145b E Gannon Dr, Festus, MO 63028-2611 | 2006-08-18 |
| 1316908155 | Nabil Ahmad | Physical Medicine & Rehabilitation | 12855 N 40 Dr Ste 275, Saint Louis, MO 63141-8667 | 2006-03-31 |
| 1427035955 | Gurpreet Padda | Physical Medicine & Rehabilitation | 5203 Chippewa St, Suite 301, Saint Louis, MO 63109-2356 | 2005-12-27 |
| Find all providers with the same taxonomy | ||||
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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.