NEUROLOGICAL DIAGNOSTICS, LLC (NPI# 1174897862) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174897862 |
| Entity Type | Organization |
| Organization Name | NEUROLOGICAL DIAGNOSTICS, LLC |
| Practice Address |
12266 Depaul Dr Suite 130 Bridgeton MO 63044-2514 |
| Mailing Address |
12266 Depaul Drive Suite 130 Bridgeton MO 63044-2514 |
| Practice Telephone | 3142912446 |
| Practice Fax Number | 3142917150 |
| Mailing Telephone | 3142912446 |
| Mailing Fax Number | 3142917150 |
| Enumeration Date | 2012-02-28 |
| Last Update Date | 2012-02-28 |
| Authorized Official Name | DR. GLENN M SHERROD (PRESIDENT) |
| Authorized Official Telephone | 3142912446 |
| Authorized Official Credential | D.O. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
30655 | MO | Allopathic & Osteopathic Physicians |
| Street Address |
12266 DEPAUL DR SUITE 130 |
| City | BRIDGETON |
| State | MO |
| Zip Code | 63044-2514 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023034857 | Crystel D Knierim | Orthopaedic Surgery | 12266 Depaul Dr, 110, Bridgeton, MO 63044-2514 | 2006-07-14 |
| 1679968135 | Elizabeth Bokermann | Physician Assistant | 12266 Depaul Dr, Suite 220, Bridgeton, MO 63044 | 2015-04-01 |
| 1871730499 | Janet R Knebel | Registered Nurse | 12266 Depaul Dr, Suite 305, Bridgeton, MO 63044-2514 | 2009-01-20 |
| 1427212471 | Orthotic and Prosthetic Lab, Inc. | Durable Medical Equipment & Medical Supplies | 12266 Depaul Dr, Suite 120, Bridgeton, MO 63044-2514 | 2008-07-17 |
| 1801958343 | Signature Health Services Inc | Obstetrics & Gynecology | 12266 Depaul Dr, Suite 200, Bridgeton, MO 63044 | 2006-12-14 |
| 1871696203 | Thomas Michael Gotsis | Dentist | 12266 Depaul Dr, Ste 325, Bridgeton, MO 63044 | 2006-09-07 |
| 1235245598 | Joshua Stuart Glaser | Surgery | 12266 Depaul Dr, Suite 305, Bridgeton, MO 63044-2516 | 2006-08-21 |
| 1255357091 | Randall D Roush | Orthopaedic Surgery | 12266 Depaul Dr, 110, Bridgeton, MO 63044-2514 | 2006-07-14 |
| 1154347995 | Terry J Weis | Orthopaedic Surgery | 12266 Depaul Dr, 110, Bridgeton, MO 63044-2514 | 2006-07-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073150017 | Zoe Marie Wadsworth | Nurse Practitioner | 12255 Depaul Dr Suite 300, Bridgeton, MO 63044 | 2019-12-10 |
| 1609412451 | Beyond Better, Best Home Health Care Services, Limited Liability Corpo | In Home Supportive Care | 3430 Mckelvey Road Ste B, Bridgeton, MO 63044 | 2019-11-26 |
| 1275189078 | Delicate Angels Home Health LLC | Home Health | 11726 St. Charles Rock Road Suite G, Bridgeton, MO 63044 | 2019-08-16 |
| 1588210082 | Nicholas Huber | Physical Therapist | 12349 Depaul Dr., Ste. 110, Bridgeton, MO 63044 | 2019-08-12 |
| 1124688858 | Michelle Bassett | Registered Nurse | 11520 St. Charles Rock Rd., Suite 106, Bridgeton, MO 63044 | 2019-06-14 |
| 1336703883 | Elena A Barrow | Nurse Practitioner | 12255 Depaul Dr, Suite 260, Bridgeton, MO 63044 | 2019-04-30 |
| 1487123105 | Laura N Steiner | Registered Nurse | Gateway Pediatrics, Ltd, 12255 Depaul Drive, Suite 460 North Medical Building, Bridgeton, MO 63044 | 2018-11-26 |
| 1205310950 | Danielle Mathis | Nurse Practitioner | 3440 Depaul Lane Suite 201, Bridgeton, MO 63044 | 2018-09-19 |
| 1588163570 | Thoughts Out Loud Counseling, LLC | Social Worker | 11520 St. Charles Rock Road Suite 101, Bridgeton, MO 63044 | 2018-02-06 |
| 1912411430 | Breanna Victoria Hayes | Counselor | 3165 Mckevley Road, Suite 200, Bridgeton, MO 63044 | 2017-11-20 |
| Find all providers in zip 63044 | ||||
| Taxonomy Code | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578651675 | Sharan Rampal | Psychiatry & Neurology | 60 Landis Ave, Bridgeton, NJ 08302-4326 | 2006-10-11 |
| 1750329611 | Waqar U. Mirza | Psychiatry & Neurology | 12266 De Paul Drive, Suite 225, Bridgeton, MO 63044-2514 | 2006-06-03 |
| 1447237870 | Daniel T Mattson | Psychiatry & Neurology | 12266 De Paul Dr Ste 100, Bridgeton, MO 63044-2541 | 2005-12-28 |
| 1255328100 | Amer Alshekhlee | Psychiatry & Neurology | 12255 Depaul Dr, Suite 200, Bridgeton, MO 63044 | 2005-10-05 |
| 1639534654 | Waqar Ulislam Mirza Md | Psychiatry & Neurology | 12277 De Paul Dr, Suite 401, Bridgeton, MO 63044-2516 | 2015-12-17 |
| 1568802148 | Chizoba Joakin Ezepue | Psychiatry & Neurology | 12266 De Paul Dr Ste 100, Bridgeton, MO 63044-2541 | 2013-06-27 |
| 1003184078 | Sharan Rampal Mdpa | Psychiatry & Neurology | 60 Landis Ave, Bridgeton, NJ 08302-4326 | 2011-12-06 |
| 1801100748 | Rashid Zia, M.d., PC | Psychiatry & Neurology | 3466 Bridgeland Dr, Ste. 150, Bridgeton, MO 63044-2606 | 2010-08-03 |
| 1245493402 | Siddharth Kaul | Psychiatry & Neurology | 12266 De Paul Dr Ste 100, Bridgeton, MO 63044-2541 | 2008-07-08 |
| 1164683447 | Xinrong Lu | Psychiatry & Neurology | 12266 De Paul Dr Ste 100, Bridgeton, MO 63044-2541 | 2008-06-19 |
| Find all providers in BRIDGETON | ||||
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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.