MR. JUSTIN DWAYNE ELLIOTT (NPI# 1164824447) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164824447 |
| Entity Type | Individual |
| Full Name | MR. JUSTIN DWAYNE ELLIOTT |
| Credential | ACNP |
| Practice Address |
1 Barnes Jewish Hospital Plz Saint Louis MO 63110-1003 |
| Mailing Address |
660 S Euclid Ave Cb 8054 Saint Louis MO 63110-1010 |
| Practice Telephone | 3143626973 |
| Practice Fax Number | 3143621185 |
| Mailing Telephone | 3143626973 |
| Mailing Fax Number | 3143621185 |
| Enumeration Date | 2014-09-18 |
| Last Update Date | 2019-07-19 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 364SC0200X |
Clinical Nurse Specialist Specialization: Critical Care Medicine |
2014036827 | MO | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | ENROLLED | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922469170 | Justin Michael Elliott | Occupational Therapist | 1149 W Monroe Rd, St. Louis, MI 48880 | 2016-03-16 |
| 1043539745 | Justin Elliott | Registered Nurse | 120 Page St, San Francisco, CA 94102-5811 | 2010-05-20 |
| 1437237344 | Justin M. Elliott | Radiology | 7300 N Fresno St, Fresno, CA 93720-2941 | 2006-11-01 |
| Street Address |
1 BARNES JEWISH HOSPITAL PLZ |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63110-1003 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801898010 | Jessica R Doiron | Nurse Practitioner | 1 Barnes Jewish Hospital Plz, Saint Louis, MO 63110-1003 | 2005-06-01 |
| 1295335966 | Tracy Novak | Nurse Practitioner | 1 Barnes Jewish Hospital Plz, Saint Louis, MO 63110-1003 | 2020-10-30 |
| 1437759545 | Michelle Nicole Rutter | Nurse Practitioner | 1 Barnes Jewish Hospital Plz, Saint Louis, MO 63110-1003 | 2020-10-28 |
| 1861092108 | John Michael Luker | Nurse Practitioner | 1 Barnes Jewish Hospital Plz, Saint Louis, MO 63110-1003 | 2020-10-27 |
| 1396344289 | Jordana Culanculan | Nurse Practitioner | 1 Barnes Jewish Hospital Plz, Saint Louis, MO 63110-1003 | 2020-10-21 |
| 1871192799 | Harold Anthony Tatum Jr. | Student in an Organized Health Care Education/Training Program | 1 Barnes Jewish Hospital Plz, Saint Louis, MO 63110-1003 | 2020-10-21 |
| 1245839323 | Michelle Juengling | Nurse Practitioner | 1 Barnes Jewish Hospital Plz, Saint Louis, MO 63110-1003 | 2020-10-20 |
| 1962018382 | Adeel Haq | Radiology | 1 Barnes Jewish Hospital Plz, Saint Louis, MO 63110-1003 | 2020-09-21 |
| 1568077568 | Joseph Daniel Balassi | Nurse Anesthetist, Certified Registered | 1 Barnes Jewish Hospital Plz, Saint Louis, MO 63110-1003 | 2020-09-15 |
| 1053924464 | Melissa Lee Prewitt | Nurse Practitioner | 1 Barnes Jewish Hospital Plz, Saint Louis, MO 63110-1003 | 2020-08-25 |
| 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 | 364SC0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Clinical Nurse Specialist |
| Specialization | Critical Care Medicine |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275958738 | Nelda Martin | Clinical Nurse Specialist | 1 Barnes Jewish Hospital Plz, 14300x West Pavilion, Saint Louis, MO 63110-1003 | 2014-02-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104336403 | Brooklyn Renee Brende | Clinical Nurse Specialist | 2330 E Meyer Blvd, Kansas City, MO 64132-1132 | 2017-10-02 |
| 1528449345 | Shalan Marie Stroud | Clinical Nurse Specialist | 4401 Wornall Rd, Kansas City, MO 64111-3220 | 2015-06-17 |
| 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.