ST LOUIS UNIVERSITY (NPI# 1104899459) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1104899459 |
Entity Type | Organization |
Organization Name | ST LOUIS UNIVERSITY |
Other Organization Name | SLUCARE DEPARTMENT OF RADIOLOGY |
Practice Address |
3635 Vista Ave Saint Louis MO 63110-2539 |
Mailing Address |
1831 Chestnut St Ste 650 Saint Louis MO 63103-2236 |
Practice Telephone | 3149776828 |
Practice Fax Number | 3142685116 |
Mailing Telephone | 3149776828 |
Mailing Fax Number | 3149776872 |
Enumeration Date | 2006-02-08 |
Last Update Date | 2019-06-21 |
Authorized Official Name | MRS. ALYCE LANXON (EXECUTIVE DIRECTOR) |
Authorized Official Telephone | 3149776828 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 2085B0100X |
Radiology Specialization: Body Imaging |
Allopathic & Osteopathic Physicians | ||
N | 2085N0700X |
Radiology Specialization: Neuroradiology |
Allopathic & Osteopathic Physicians | ||
N | 2085R0204X |
Radiology Specialization: Vascular & Interventional Radiology |
Allopathic & Osteopathic Physicians | ||
Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians |
Other Name | Type Code |
---|---|
SLUCare Department of Radiology | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1487869863 | St Louis University | Eyewear Supplier (Equipment, not the service) | 1755 South Grand, St Louis, MO 63104 | 2007-05-11 |
1194892463 | St Louis University | Orthopaedic Surgery | 1831 Chestnut St Ste 650, Saint Louis, MO 63103 | 2006-11-29 |
1093894842 | St Louis University | Internal Medicine | 10 Franklin, Washington, MO 63090 | 2006-11-03 |
1417035759 | St Louis University | Audiologist | 3750 Lindell, St Louis, MO 63108 | 2006-11-02 |
1992778237 | St Louis University | Urology | 3655 Vista Ave, Saint Louis, MO 63110-2539 | 2006-02-08 |
1164495412 | St Louis University | Pathology | 1402 South Grand, St Louis, MO 63104 | 2006-02-08 |
1801869136 | St Louis University | Psychiatry & Neurology | 1438 S Grand Blvd, Saint Louis, MO 63104-1027 | 2006-02-08 |
1740253095 | St Louis University | Dermatology | 1755 S Grand Blvd, Saint Louis, MO 63104-1540 | 2006-02-08 |
1184266413 | St Louis University | Pediatrics | 1465 S Grand Blvd, Saint Louis, MO 63104-1003 | 2019-10-08 |
1184908865 | St Louis University | Urology | 1465 S Grand Blvd, Saint Louis, MO 63104-1003 | 2011-09-29 |
Street Address |
3635 VISTA AVE |
City | SAINT LOUIS |
State | MO |
Zip Code | 63110-2539 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1891790689 | Rajeswari Chintapalli | Anesthesiology | 3635 Vista Ave, Saint Louis, MO 63110-2539 | 2005-06-17 |
1932711389 | Breezy Summer Stanley | Nurse Practitioner | 3635 Vista Ave, Saint Louis, MO 63110-2539 | 2020-08-18 |
1235756842 | Trisha Ann Janis | Nurse Practitioner | 3635 Vista Ave, Saint Louis, MO 63110-2500 | 2020-06-30 |
1780207167 | Michelle Reale | Speech-Language Pathologist | 3635 Vista Ave, Saint Louis, MO 63110-2539 | 2020-05-20 |
1801418926 | Jason Adam Horowitz | Student in an Organized Health Care Education/Training Program | 3635 Vista Ave, Saint Louis, MO 63110-2539 | 2020-05-12 |
1255953378 | Luke Andrew Momper | Student in an Organized Health Care Education/Training Program | 3635 Vista Ave, Saint Louis, MO 63110-2539 | 2020-05-12 |
1063034197 | Tyler Daniel Ragsdale | Student in an Organized Health Care Education/Training Program | 3635 Vista Ave, Saint Louis, MO 63110-2539 | 2020-05-12 |
1417579541 | Kelyn N Pittman | Student in an Organized Health Care Education/Training Program | 3635 Vista Ave, Saint Louis, MO 63110-2539 | 2020-05-12 |
1881216901 | Purav Sudhir Brahmbhatt | Student in an Organized Health Care Education/Training Program | 3635 Vista Ave, Saint Louis, MO 63110-2539 | 2020-05-12 |
1578185989 | Feras Kaid | Radiologic Technologist | 3635 Vista Ave, Saint Louis, MO 63110-2539 | 2020-05-08 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1659971992 | Carrie Ellen Smith | Nurse Practitioner | Mailstop 90-00-174, One Barnes-jewish Plaza, St. Louis, MO 63110 | 2020-10-27 |
1881210466 | Michelle Amanda Freilich | Internal Medicine | Barnes-jewish Plaza, St. Louis, MO 63110 | 2020-06-19 |
1245856046 | Jeevin Shahi | Radiology | 3685 Vista Avenue, Center for Radiation Medicine, St. Louis, MO 63110 | 2020-06-18 |
1497371314 | Wilson Eduardo Rodriguez | Student in an Organized Health Care Education/Training Program | 1008 S. Spring, St Louis, MO 63110 | 2020-06-17 |
1578184065 | Kathryn Kay Lindsay | Registered Nurse | Saint Louis University Dept of Surgery, 3635 Vista Ave 3dt, St Louis, MO 63110 | 2020-05-06 |
1881232700 | Ashley Diane Pace | Nurse Practitioner | 1 Parkview Place, Shoenberg 6900, St. Louis, MO 63110 | 2019-12-11 |
1619520418 | Krithika Damodar Shenoy | Pathology | 660 Euclid Avenue, One Barnes Jewish Hospital Plaza, St. Louis, MO 63110 | 2019-07-20 |
1467912550 | Ian Ferguson | Dermatology | 660 S Euclid Ave., Cb 8123, St. Louis, MO 63110 | 2019-03-23 |
1760978688 | Ihab Hassanieh | Student in an Organized Health Care Education/Training Program | 33660 Vista Ave, St. Louis, MO 63110 | 2018-07-03 |
1336634500 | Martin K Mwangi | Pediatrics | 1 Childrens Place, 3s34, St. Louis, M, MO 63110 | 2018-06-28 |
Find all providers in zip 63110 |
Taxonomy Code | 2085R0202X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Radiology |
Specialization | Diagnostic Radiology |
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1609130566 | Kristin Harris Drake | Radiology | 621 S New Ballas Rd Ste 23a, Saint Louis, MO 63141 | 2012-06-26 |
1093083016 | William G Crawford | Radiology | 61 Crestwood Dr, Saint Louis, MO 63105-3020 | 2011-12-05 |
1558657643 | Joseph Gary Livingston | Radiology | One Barnes-jewsih Hospital Plaza, Mailstop 90-09-355, Saint Louis, MO 63110 | 2011-06-27 |
1013219344 | Pure Imaging LLC | Radiology | 12345 West Bend Drive, Saint Louis, MO 63128-2104 | 2010-11-18 |
1881884658 | Zhengming Gu | Radiology | 9240 Radiom Dr, Saint Louis, MO 63123-5545 | 2007-07-27 |
1306057310 | Mohammed Ali Abbas | Radiology | 1402 S Grand Blvd Rm 260, Saint Louis, MO 63104-1004 | 2007-05-24 |
1104040963 | Saadoon Kadir | Radiology | 2909 Netherton Dr, Saint Louis, MO 63136-4677 | 2007-04-12 |
1376612739 | Carl Joseph Aschkenasi | Radiology | 898 Alanson Dr, Saint Louis, MO 63132-5039 | 2006-11-07 |
1629182829 | Jeffery A Hardy | Radiology | 2344 Hampton Ave, Saint Louis, MO 63139-2909 | 2006-08-18 |
1124132436 | Alfred D Shaplin | Radiology | 1034 S Brentwood Blvd Ste 280, Saint Louis, MO 63117-1221 | 2006-08-17 |
Find all providers in SAINT LOUIS |
City | SAINT LOUIS |
Zip Code | 63110 |
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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.