GEROMED, LLC


Address: 4675 S Grand Blvd, Saint Louis, MO 63111-1462
Phone: 3147528600

GEROMED, LLC (NPI# 1184755118) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1184755118
Entity Type Organization
Organization Name GEROMED, LLC
Practice Address 4675 S Grand Blvd
Saint Louis
MO 63111-1462
Practice Telephone 3147528600
Practice Fax Number 3147528601
Mailing Telephone 3147528600
Mailing Fax Number 3147528601
Enumeration Date 2007-03-09
Last Update Date 2008-05-27
Authorized Official Name DR. TONY THIEN TANG (OWNER)
Authorized Official Telephone 3147528600
Authorized Official Credential M. D.
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207RG0300X Internal Medicine
Specialization: Geriatric Medicine
Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
MO 208393702 05
PROVIDER NPI 1417040114 01
MO 208442400 05
PROVIDER NPI 1023026804 01
MO 508753001 05

Office Location

Street Address 4675 S GRAND BLVD
City SAINT LOUIS
State MO
Zip Code 63111-1462

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1992291660 Ebony Cannon Behavior Technician 7700 Minosotta Ave, St.louis, MO 63111 2018-07-06
1811310212 Danny Brown Home Health 5328 Virginia, Saint Louis, MO 63111 2014-01-22
1548387681 Raymond Joseph Skosky Dentist 5530 Virginia Avenue, Saint Louis, MO 63111 2007-03-23
1972666782 Diane P Hamill Optometrist 1012 Loughborough Commons, St. Louis, MO 63111 2006-12-19
1073673828 Bethesda Long Term Care, Inc. Custodial Care Facility 4431 South Broadway, St. Louis, MO 63111 2006-12-11
1669542668 Anna D Naumovich Internal Medicine 5205 South Grand Ave, St Louis, MO 63111 2006-11-08
1417040114 Tony Thien Tang Internal Medicine 4675 South Grand Blvd., St. Louis, MO 63111 2006-10-02
1790736171 Robert Clarence Egan Surgery 3535 South Jefferson Ste 101, Ste 101, St Louis, MO 63111 2006-05-12
1790340438 Marco Samuel Garcia Student in an Organized Health Care Education/Training Program 401 Holly Hills Ave, Saint Louis, MO 63111 2019-05-08
1154717593 Nucrown, LLC Optometrist 1012 Loughborough Commons, Saint Louis, MO 63111 2015-04-13
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Taxonomy Information

Taxonomy Code 207RG0300X
Grouping Allopathic & Osteopathic Physicians
Classification Internal Medicine
Specialization Geriatric Medicine

Taxonomy Definition

An internist who has special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes and the hospital.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source]
- Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1023592946 Institute of Medicine LLC Internal Medicine 6824 Balson Ave, Saint Louis, MO 63143-2603 2018-09-17
1104235241 Generation Clinical Partners LLC Internal Medicine 11500 Olive Blvd Ste 235, Saint Louis, MO 63141-7141 2014-08-02
1558563890 Hassan Dawoud Elsiddig Internal Medicine 3660 Vista Ave # 204, Saint Louis, MO 63110-2540 2007-05-31
1871795104 Shehla Sadiq Internal Medicine 3660 Vista Ave # 2104, Saint Louis, MO 63110-2540 2007-05-31
1851446207 Poonam M Jain Internal Medicine 1 Meadow Acres, Saint Louis, MO 63124-1460 2007-01-24
1154484673 Miriam B Rodin Internal Medicine 1402 S Grand Blvd Rm 238, Division of Geriatric Medicine, Saint Louis, MO 63104-1004 2006-12-18
1992815906 Susan Robinson Reeds Internal Medicine 8 Millstone Campus Dr, Ste 1500, Saint Louis, MO 63146-5766 2006-08-30
1780602417 Monique Marie Williams Internal Medicine 969 N Mason Rd Ste 145, Saint Louis, MO 63141 2006-07-18
1124073630 Rafi Thomas Kevorkian Internal Medicine 522 N New Ballas Rd Ste 317, Saint Louis, MO 63141-6840 2006-05-23
1902881279 Wit Anthony Jamry Internal Medicine 5621 Delmar Blvd, #105, Saint Louis, MO 63112-2656 2005-12-09
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Competitor

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City SAINT LOUIS
Zip Code 63111

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Dataset Information

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.

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