CHARLES ROBERT HARTMAN JR. (NPI# 1205819034) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205819034 |
| Entity Type | Individual |
| Full Name | CHARLES ROBERT HARTMAN JR. |
| Credential | DO |
| Practice Address |
300 Medical Plz Ste 310 Lake St Louis MO 63367-1484 |
| Mailing Address |
10890 Veterans Memorial Parkway Lake St Louis MO 63367-1475 |
| Practice Telephone | 6366252662 |
| Mailing Telephone | 6365616801 |
| Mailing Fax Number | 6366251601 |
| Enumeration Date | 2005-11-25 |
| Last Update Date | 2020-11-04 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | R5P00 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 248492001 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 10890 Veterans Memorial Parkway, Lake St Louis, MO 633671475 | 6365616801 | 6366251601 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124352869 | Charles Hartman | Dentist | 4301 Ne Tillamook St, Portland, OR 97213-1315 | 2009-09-29 |
| 1023290715 | Charles Ray Hartman Jr. | Physical Therapy Assistant | 5500 Brooktree Rd, Suite 102, Wexford, PA 15090-9260 | 2007-12-04 |
| Street Address |
300 MEDICAL PLZ STE 310 |
| City | LAKE ST LOUIS |
| State | MO |
| Zip Code | 63367-1484 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609272897 | Victoria Lal | Nurse Practitioner | 300 Medical Plz Ste 310, Lake St Louis, MO 63367-1484 | 2014-11-14 |
| 1558565077 | Deborah W La Scola | Specialist | 300 Medical Plz Ste 310, Lake St Louis, MO 63367-1484 | 2007-06-11 |
| 1730101874 | Joseph Franklin Rodemann | Internal Medicine | 300 Medical Plz Ste 310, Lake St Louis, MO 63367-1484 | 2006-07-25 |
| 1255362430 | Thomas Mark Leibold | Surgery | 300 Medical Plz Ste 310, Lake St Louis, MO 63367-1484 | 2006-07-05 |
| 1073568382 | Thomas Harold Landon | Urology | 300 Medical Plz Ste 310, Lake St Louis, MO 63367-1484 | 2006-05-24 |
| 1295796118 | David A. Nickel | Surgery | 300 Medical Plz Ste 310, Lake St Louis, MO 63367-1484 | 2006-03-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295376697 | Stacy Brown | Counselor | 1216 Flagstone Terrace, Lake St. Louis, MO 63367 | 2019-10-07 |
| 1083172449 | Katie D Schmidt | Nurse Practitioner | 300 Medical Plz Ste 150, Lake St Louis, MO 63367 | 2019-03-05 |
| 1932639739 | Eren Taylor-scaggs | Social Worker | 112 Lake St. Louis Blvd, Lake St. Louis, MO 63367 | 2017-06-14 |
| 1184169203 | Be The Change Counseling Services | Community/Behavioral Health | 206 Centre On The Lake, Lake St. Louis, MO 63367 | 2016-12-28 |
| 1568812535 | Brittanie Weinhaus | Family Medicine | 6261 Ronald Regan Dr Ste #b19, Lake St. Louis, MO 63367 | 2016-06-20 |
| 1821445099 | Matt Beamer | Skilled Nursing Facility | 2885 Technology Drive, Lake St. Louis, MO 63367 | 2016-05-18 |
| 1710349642 | Jennifer Gandolfo | Early Intervention Provider Agency | 710 Abbottsford Ct., Lake St. Louis, MO 63367 | 2016-03-21 |
| 1760862361 | Joaquin Francisco Sumaya | Chiropractor | 11104 Veterans Memorial Pkwy., Lake Saint Louis, MO 63367 | 2015-06-09 |
| 1619214566 | Daniel Scott Terry | Counselor | 1000 Edgewater Pt Ste 401, Lake St Louis, MO 63367 | 2013-01-12 |
| 1437415551 | Cherie Jean Coletta | Nurse Practitioner | 100 Medical Plaza Dr, Emergency Department, Lake Saint Louis, MO 63367 | 2012-04-03 |
| Find all providers in zip 63367 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| 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 Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558642421 | Andrea Behr | Surgery | 400 Medical Plz Ste 10, Lake St Louis, MO 63367-1490 | 2011-09-06 |
| 1255362430 | Thomas Mark Leibold | Surgery | 300 Medical Plz Ste 310, Lake St Louis, MO 63367-1484 | 2006-07-05 |
| 1295796118 | David A. Nickel | Surgery | 300 Medical Plz Ste 310, Lake St Louis, MO 63367-1484 | 2006-03-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134623317 | Kuirong Jiang | Surgery | 1 Hospital Dr Rm Mc520, Columbia, MO 65212-1000 | 2018-03-21 |
| 1962926311 | Blaire Lori Anderson | Surgery | 4921 Parkview Place Ste 8c, St Louis, MO 63110 | 2017-07-27 |
| 1578084349 | Shoaib Safiullah | Surgery | 1 Hospital Dr # Dc075.00, Columbia, MO 65212-1000 | 2017-07-03 |
| 1003336934 | Bradley Kushner | Surgery | 660 S Euclid Ave Fl 9, Saint Louis, MO 63110-1010 | 2017-06-21 |
| 1982088571 | Maxwell Tanyi Fohtung | Surgery | 4949 W Pine Blvd, Saint Louis, MO 63108 | 2015-07-14 |
| 1376920538 | Jordan M Kirsch | Surgery | 660 S. Euclid Ave, Cb 8109, Saint Louis, MO 63110-1020 | 2015-04-27 |
| 1194117861 | Kaitlyn Marie Rountree | Surgery | 1 Hospital Dr # Mc404, Columbia, MO 65212-1000 | 2015-03-04 |
| 1003231002 | Mysorekar Surgical | Surgery | 8342 Delcrest Dr, Apt 303, Saint Louis, MO 63124-2100 | 2014-02-27 |
| 1588099725 | Francis Milton Corry | Surgery | 2859 E. Utica, Springfield, MO 65804 | 2013-09-06 |
| 1710327879 | Jason Matthew Loden | Surgery | 1333 S Sam Houston Blvd Ste C, Houston, MO 65483-2046 | 2013-07-03 |
| Find all providers with the same taxonomy | ||||
| City | LAKE ST LOUIS |
| Zip Code | 63367 |
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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.