MISSOURI NEURODIAGNOSTICS, LLC (NPI# 1114377223) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114377223 |
| Entity Type | Organization |
| Organization Name | MISSOURI NEURODIAGNOSTICS, LLC |
| Practice Address |
100 Chesterfield Business Pwky Ste. 200, Office 238 Chesterfield MO 63005-1271 |
| Mailing Address |
4545 Fuller Dr Suite 100 Irving TX 75038-6530 |
| Practice Telephone | 3143321340 |
| Practice Fax Number | 8662794704 |
| Mailing Telephone | 4699958416 |
| Mailing Fax Number | 8662794704 |
| Enumeration Date | 2016-06-20 |
| Last Update Date | 2020-10-12 |
| Authorized Official Name | CHARLES ALVAREZ (CEO) |
| Authorized Official Telephone | 4699958416 |
| Is Organization Subpart | Y |
| Parent Organization Name | ALLIANCE FAMILY OF COMPANIES, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities | ||
| N | 261QS1200X |
Clinic/Center Specialization: Sleep Disorder Diagnostic |
Ambulatory Health Care Facilities | ||
| Y | 293D00000X | Physiological Laboratory | Laboratories |
| Street Address |
100 CHESTERFIELD BUSINESS PWKY STE. 200, OFFICE 238 |
| City | CHESTERFIELD |
| State | MO |
| Zip Code | 63005-1271 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063901254 | Ryan Hewkin | Chiropractor | 17684 Chesterfield Airport Road, Chesterfield, MO 63005 | 2018-05-03 |
| 1093224487 | All Family Matters, LLC | In Home Supportive Care | 100 Chesterfield Business Pkwy Ste 200, Chesterfield, MO 63005 | 2017-09-28 |
| 1437681293 | Emily Therese Harpel | Pharmacist | 691 Trade Center Blvd, Chesterfield, MO 63005 | 2017-03-31 |
| 1831543826 | Leslie Noel Chanasue | Family Medicine | 17701 Edison Ave Ste 101, Chesterfield, MO 63005 | 2016-04-16 |
| 1497112874 | Jordan Kimler | Nurse Practitioner | 124 Chesterfield Towne Ctr, Chesterfield, MO 63005 | 2016-01-15 |
| 1265850556 | Richard George Rougeau | General Practice | 17679 Wildridge Drive, Wildwood, MO 63005 | 2014-04-03 |
| 1679912554 | Ceara M Barmeier | Physician Assistant | 17300 N Outer 40 Rd #101, Chesterfield, MO 63005 | 2013-06-24 |
| 1265794911 | Regeneration Orthopedics, LLC | Anesthesiology | 6 Mcbride & Son Center Dr., Ste 204, Chesterfield, MO 63005 | 2012-06-08 |
| 1528334984 | Syed Tanveer Haider | Radiologic Technologist | 16502 Barrister Lane, Chesterfield, MO 63005 | 2012-03-29 |
| 1144591041 | Sensible Dental - Chesterfield | Dentist | 100 Thf Blvd., Chesterfield, MO 63005 | 2012-01-24 |
| Find all providers in zip 63005 | ||||
| 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 |
| 1063415073 | King's Medical Imaging Creve Coeur, LLC | Physiological Laboratory | 11756 Olive Street Rd, Creve Coeur, MO 63141 | 2005-05-23 |
| 1215397153 | Missouri Diagnostic Services, LLC | Physiological Laboratory | 1517 Copper Rd, Holts Summit, MO 65043-2033 | 2016-03-04 |
| Find all providers with the same taxonomy | ||||
| City | CHESTERFIELD |
| Zip Code | 63005 |
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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.