SSM BERLAND EUREKA IMAGING SERVICES LLC (NPI# 1194949727) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194949727 |
| Entity Type | Organization |
| Organization Name | SSM BERLAND EUREKA IMAGING SERVICES LLC |
| Practice Address |
#20 The Legends Parkway Drive Suite 160 Eureka MO 63025 |
| Mailing Address |
774 N New Ballas Road St Louis MO 63141-6716 |
| Practice Telephone | 6369381656 |
| Practice Fax Number | 6369381674 |
| Mailing Telephone | 3145671656 |
| Mailing Fax Number | 3145670622 |
| Enumeration Date | 2007-04-13 |
| Last Update Date | 2008-01-15 |
| Authorized Official Name | ROBERT D SEELIG (PRESIDENT) |
| Authorized Official Telephone | 3145671656 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | MO CAID | 715484606 | 01 |
| Street Address |
#20 THE LEGENDS PARKWAY DRIVE SUITE 160 |
| City | EUREKA |
| State | MO |
| Zip Code | 63025 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992173736 | Sharon Henderson | Specialist/Technologist | 4525 Missouri 109, Eureka High School, Eureka, MO 63025 | 2015-09-10 |
| 1750654372 | Charles George Thierauf | Radiology | 463 Meramec View Drive, Eureka, MO 63025 | 2012-02-13 |
| 1326273723 | Carol Johnston | Case Management | 1417 West 5th Street, Eureka, MO 63025 | 2009-05-28 |
| 1245485408 | Leslie Arroyo Robins | Family Medicine | 20 Legends Parkway, Suite 110, Eureka, MO 63025 | 2008-12-01 |
| 1740439199 | Kristi A Moore | Internal Medicine | 20 The Legends Parkway, Eureka, MO 63025 | 2008-09-10 |
| 1356508758 | Michael W. Noble, Dmd, PC | Dentist | 60 East North Street, Eureka, MO 63025 | 2008-05-22 |
| 1265640973 | Christopher A Michalek | Social Worker | 643 Vista Hills Ct, Eureka, MO 63025 | 2007-05-18 |
| 1396966883 | Mitzi S Pasch | Social Worker | 1 Hilltop Village Center, Ste. 3a, Eureka, MO 63025 | 2007-05-01 |
| 1548388077 | Heather D Gjorgjievski | Family Medicine | 103 Hilltop Village Shopping Center Dr., Eureka, MO 63025 | 2007-03-26 |
| 1568523900 | Apn First Assistants | Nurse Practitioner | 179 Sierra Village Drive, Eureka, MO 63025 | 2006-12-12 |
| Find all providers in zip 63025 | ||||
| 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 |
|---|---|---|---|---|
| 1750654372 | Charles George Thierauf | Radiology | 463 Meramec View Drive, Eureka, MO 63025 | 2012-02-13 |
| 1811946296 | Dean Gregory Holland | Radiology | 2330 Buhne St, Eureka, CA 95501-3237 | 2006-05-10 |
| 1194795849 | James Bryan Moore IIi | Radiology | 2700 Dolbeer Ave, Eureka, CA 95501 | 2006-01-25 |
| 1538211719 | Humboldt Radiology Medical Group Inc | Radiology | 2675 Harris St, Eureka, CA 95503-4806 | 2007-01-17 |
| 1285786350 | Humboldt Radiology Medical Group Inc. | Radiology | 2700 Dolbeer St, Eureka, CA 95501-4736 | 2007-01-17 |
| 1972655058 | Humboldt Radiology Medical Group Inc | Radiology | 2200 Harrison Ave, Eureka, CA 95501-3215 | 2007-01-17 |
| 1326154196 | Humboldt Radiology Medical Group Inc | Radiology | 2330 Buhne St, Eureka, CA 95501 | 2006-08-22 |
| 1699784967 | Donald Craig Wheeler | Radiology | 550 Russ St, Eureka, CA 95501-4451 | 2006-08-05 |
| 1184673568 | Matthew Marc Fluke | Radiology | 2330 Buhne St, Eureka, CA 95501 | 2006-05-10 |
| 1700835188 | Abraham Pera | Radiology | 2330 Buhne St, Eureka, CA 95501 | 2006-05-10 |
| Find all providers in EUREKA | ||||
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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.