PHYSICIAN SPECIALISTS OF ST LUKES LLC (NPI# 1235168410) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235168410 |
| Entity Type | Organization |
| Organization Name | PHYSICIAN SPECIALISTS OF ST LUKES LLC |
| Practice Address |
14709 Olive Blvd Chesterfield MO 63017-2221 |
| Mailing Address |
232 S Woods Mill Rd Chesterfield MO 63017-3417 |
| Practice Telephone | 3143175700 |
| Mailing Telephone | 3145762490 |
| Mailing Fax Number | 3145762473 |
| Enumeration Date | 2006-07-01 |
| Last Update Date | 2018-05-10 |
| Authorized Official Name | RICK SONNE (DIRECTOR) |
| Authorized Official Telephone | 3145762490 |
| Is Organization Subpart | Y |
| Parent Organization Name | ST. LUKE'S HOSPITAL |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207RC0200X |
Internal Medicine Specialization: Critical Care Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians | ||
| N | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians | ||
| N | 208100000X | Physical Medicine & Rehabilitation | Allopathic & Osteopathic Physicians | ||
| Y | 207P00000X | Emergency Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 506278308 | 05 | |
| MO | RR MEDICARE | DF0124 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1630 Market Center Dr Ste 201, O Fallon, MO 633688407 | 3142056030 | |
| 2345 Dougherty Ferry Rd, Saint Louis, MO 631223313 | 3149669100 | |
| 14709 Olive Blvd, Chesterfield, MO 630172221 | 3143175700 |
| Street Address |
14709 OLIVE BLVD |
| City | CHESTERFIELD |
| State | MO |
| Zip Code | 63017-2221 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144866260 | Kathryn Jane Zigarowicz | Physical Therapist | 14709 Olive Blvd, Chesterfield, MO 63017-2221 | 2019-11-24 |
| 1033512017 | Rehab In Action, LLC | Physical Medicine & Rehabilitation | 14709 Olive Blvd, Chesterfield, MO 63017-2221 | 2014-10-03 |
| 1518255991 | Knd Development 59 LLC | Hospitalist | 14709 Olive Blvd, Chesterfield, MO 63017-2221 | 2011-07-19 |
| 1255587747 | St. Luke's Rehabilitation Hospital, L.L.C. | Rehabilitation Hospital | 14709 Olive Blvd, Chesterfield, MO 63017-2221 | 2008-08-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114549193 | Kathryn E Bos | Student in an Organized Health Care Education/Training Program | 873 Apt N Foxsprings Dr, Chesterfield, MO 63017 | 2020-05-12 |
| 1700415171 | Charles H. Edwards | Physical Therapist | 224 South Woods Millrd., Suite 610 South, Chesterfield, MO 63017 | 2020-04-07 |
| 1003454562 | Stephanie Henningsen | Physical Therapy Assistant | 307 S Woods Rd, Chesterfield, MO 63017 | 2019-12-16 |
| 1831746296 | Star Lynn Sutton | Occupational Therapy Assistant | 15207 Olive Boulevard, Chesterfield, MO 63017 | 2019-08-21 |
| 1639738438 | Van Amburg & Busiek Md's, LLC | Pharmacy | 232 S Woodsmill Road, Suite 330 East, Chesterfield, MO 63017 | 2019-06-06 |
| 1306306865 | Margaret Mary Wynn | Nurse Practitioner | 15740 South Outer Road, Chesterfield, MO 63017 | 2019-03-21 |
| 1205393089 | Kimberly Danielle | Nurse Practitioner | 744 Forest Trace Dr, Chesterfield, MO 63017 | 2019-02-27 |
| 1457823965 | Allison Joy Mcgrail | Dietitian, Registered | 45740 S Outer Forty Rd, Chesterfield, MO 63017 | 2018-12-21 |
| 1316418080 | Julie Lefere | Social Worker | Mercy Virtual Care Center, 15740 S Outer 40 Rd, Chesterfield, MO 63017 | 2018-12-06 |
| 1336629641 | Catherine Dolphin Smith | Nurse Practitioner | 224 S Woods Mill Rd Ste 500, Chesterfield, MO 63017 | 2018-08-16 |
| Find all providers in zip 63017 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275088676 | Medepxress Urgent Care, PC - Michigan | Emergency Medicine | 34875 23 Mile Rd, Chesterfield, MI 48047-3647 | 2016-08-16 |
| 1053630525 | Joseph Charles Mason | Emergency Medicine | 15530 Twisted Cedar Ct, Chesterfield, VA 23832-2658 | 2010-05-24 |
| 1760555890 | Glenn Whittaker Mitchell | Emergency Medicine | 14528 S Outer 40 Ste 100, Chesterfield, MO 63017-5743 | 2006-11-16 |
| 1205869732 | David S Lickerman | Emergency Medicine | 232 S Woods Mill Road, Chesterfield, MO 63017-3417 | 2006-07-08 |
| 1144264474 | Hugh Hemsley | Emergency Medicine | 12624 Chesdin Landing Dr, Chesterfield, VA 23838-3231 | 2006-06-16 |
| 1609815240 | Roque S Ramos | Emergency Medicine | 14897 Clayton Rd, Ste 100, Chesterfield, MO 63017-7887 | 2006-06-06 |
| 1376597302 | Debra Gulyanics | Emergency Medicine | 307 Western Dr, Chesterfield, IN 46017-1230 | 2006-05-22 |
| 1750334652 | James E Nahlik | Emergency Medicine | 15563 Parasol Dr, Chesterfield, MO 63017-7460 | 2006-05-19 |
| 1265494108 | Michael David Metzler | Emergency Medicine | 14824 Brook Hill Dr, Chesterfield, MO 63017-7931 | 2006-04-05 |
| 1063488401 | Gary P Lessmann | Emergency Medicine | 201 W Manor Dr, Chesterfield, MO 63017-2970 | 2006-02-26 |
| Find all providers in CHESTERFIELD | ||||
| City | CHESTERFIELD |
| Zip Code | 63017 |
Please comment or provide details below to improve the information on PHYSICIAN SPECIALISTS OF ST LUKES LLC.
| 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.