KING'S MEDICAL IMAGING CREVE COEUR, LLC (NPI# 1063415073) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063415073 |
| Entity Type | Organization |
| Organization Name | KING'S MEDICAL IMAGING CREVE COEUR, LLC |
| Other Organization Name | ADVANCED IMAGING CREVE COEUR |
| Practice Address |
11756 Olive Street Rd Creve Coeur MO 63141 |
| Mailing Address |
1894 Georgetown Rd Hudson OH 44236-4058 |
| Practice Telephone | 3145693900 |
| Practice Fax Number | 3145692734 |
| Mailing Telephone | 3306533968 |
| Mailing Fax Number | 3306561660 |
| Enumeration Date | 2005-05-23 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MS. V. RENAE COYNE (DIRECTOR OF BILLING) |
| Authorized Official Telephone | 3306533968 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 293D00000X | Physiological Laboratory | Laboratories |
| Other Name | Type Code |
|---|---|
| Advanced Imaging Creve Coeur | Doing Business As Name - Organization |
| Street Address |
11756 OLIVE STREET RD |
| City | CREVE COEUR |
| State | MO |
| Zip Code | 63141 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679102842 | Noor Ramadan | Pharmacist | 628 North New Ballad Road, Suite A, Creve Coeur, MO 63141 | 2020-04-08 |
| 1497381206 | Washington University | Durable Medical Equipment & Medical Supplies | 1044 North Mason Road, Suite 110/210, St. Louis, MO 63141 | 2020-03-13 |
| 1154956498 | Ashleigh Clendenny | Physician Assistant | Mercy Hospital St. Louis, 615 S New Ballas Rd, St. Louis, MO 63141 | 2020-03-06 |
| 1801429410 | Emili Lou Haley | Registered Nurse | 650 Maryville Drive, St Louis, MO 63141 | 2020-02-21 |
| 1629553110 | Rebecca Kathleen Pike | Social Worker | West County Psychological Associates, 12125 Woodcrest Executive Drive #110, St. Louis, MO 63141 | 2018-10-01 |
| 1649756099 | River City Sedation Associates, LLC | Nurse Anesthetist, Certified Registered | 12855 N 40 Dr Ste 150, Saint Louis, MO 63141 | 2018-07-18 |
| 1205333952 | Ear Care and Hearing of St. Louis | Hearing Aid Equipment | 11630 Studt Ave Ste 210, Creve Coeur, MO 63141 | 2018-04-10 |
| 1659897486 | Erin Goodman | Physical Therapist | 10560 Old Olive St. Rd, Suite 100, Creve Coeur, MO 63141 | 2017-08-14 |
| 1093230450 | Center for Urologic Surgery LLC | Clinic/Center | 12855 N 40 Dr Ste 100, Saint Louis, MO 63141 | 2017-08-07 |
| 1871016105 | Jacob Farley Tanner | Specialist/Technologist | 1054 Town and Four Parkway Dr, Creve Coeur, MO 63141 | 2017-07-19 |
| Find all providers in zip 63141 | ||||
| Taxonomy Code | 293D00000X |
| Grouping | Laboratories |
| Classification | Physiological Laboratory |
| A laboratory that operates independently of a hospital and physician’s office to furnish physiological diagnostic services (e.g. EEG’s , EKG’s, scans, etc.). Facilities offering ONLY physiological services are not certified as independent laboratories. If an independent laboratory offers physiological services IN ADDITION to clinical laboratory services, they are surveyed only for compliance with the clinical laboratory regulations because there are no health and safety regulations for physiological services. |
| Notes: Source: Paraphrased from the Medicare Carrier Manual, Section 2070.5. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760855043 | Midwest Mobile Imaging | Physiological Laboratory | 408 Washington Ave Ste 130, West Plains, MO 65775-3404 | 2015-11-09 |
| 1750757415 | Mobilis Health, LLC | Physiological Laboratory | 4240 Duncan Ave, Second Floor, Saint Louis, MO 63110-1123 | 2015-08-18 |
| 1184026098 | Braincare, LLC | Physiological Laboratory | 303 N Stadium Blvd, Ste 249, Columbia, MO 65203-1493 | 2014-09-23 |
| 1043539190 | Home Oximetry and Sleep Testing of Missouri | Physiological Laboratory | 1720 Kansas Ave, Kansas City, MO 64127-2628 | 2010-05-27 |
| 1730134784 | Nitelife LLC | Physiological Laboratory | 100 Sarah Ann Blvd, Troy, MO 63379-2038 | 2006-05-24 |
| 1437108842 | Biotech X-ray Inc | Physiological Laboratory | 1065 Executive Parkway Dr Ste 220, Saint Louis, MO 63141-6367 | 2006-05-10 |
| 1235194002 | Sleep Kwest, LLC | Physiological Laboratory | 101b Progress Pkwy, Sullivan, MO 63080-2359 | 2006-04-17 |
| 1710971080 | Specialized Imaging Services, Inc. | Physiological Laboratory | 9785 Mackenzie Rd, Suite 101, Saint Louis, MO 63123-5438 | 2005-09-01 |
| 1215397153 | Missouri Diagnostic Services, LLC | Physiological Laboratory | 1517 Copper Rd, Holts Summit, MO 65043-2033 | 2016-03-04 |
| 1417325143 | Biomedical Imaging LLC | Physiological Laboratory | 3450 Bridgeland Dr, Suite F, Bridgeton, MO 63044-2605 | 2015-09-11 |
| Find all providers with the same taxonomy | ||||
| City | CREVE COEUR |
| Zip Code | 63141 |
Please comment or provide details below to improve the information on KING'S MEDICAL IMAGING CREVE COEUR, LLC.
| 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.