KATHLEEN MILES NIKODYM (NPI# 1235210162) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235210162 |
| Entity Type | Individual |
| Full Name | KATHLEEN MILES NIKODYM |
| Credential | PA |
| Practice Address |
400 1st Capitol Dr Ste 100 Saint Charles MO 63301-2881 |
| Mailing Address |
Po Box 955534 Saint Louis MO 63195-5534 |
| Practice Telephone | 6363328455 |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2020-10-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
2002004796 | MO | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1150 Graham Rd, Ste 102, Florissant, MO 630318077 | 3148375555 |
| Street Address |
400 1ST CAPITOL DR STE 100 |
| City | SAINT CHARLES |
| State | MO |
| Zip Code | 63301-2881 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891728051 | Jody T Jachna | Orthopaedic Surgery | 400 1st Capitol Dr Ste 100, Saint Charles, MO 63301-2881 | 2006-07-09 |
| 1265627210 | Mohsin Ehsan | Internal Medicine | 400 1st Capitol Dr Ste 100, Saint Charles, MO 63301-2881 | 2007-09-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376189910 | Kelsey Fix | Occupational Therapist | 3228 Silvertrail Dr, Saint Charles, MO 63301 | 2019-11-19 |
| 1063056307 | Compass Health, Inc. | Clinic/Center | 3075 New Town Blvd, Saint Charles, MO 63301 | 2019-10-30 |
| 1558921361 | Next Steps Therapy & Coaching, LLC | Clinic/Center | 1040 Fairgrounds Road, St. Charles, MO 63301 | 2019-06-14 |
| 1093297426 | Delia Smith | Specialist/Technologist | 209 S Kingshighway, St. Charles, MO 63301 | 2018-09-01 |
| 1285136754 | Helping Hand Home Healthcare, LLC | Home Health | 1360 S 5th Street, Suite 278, Saint Charles, MO 63301 | 2018-03-01 |
| 1972043107 | Robert Christopher Loynd | Otolaryngology | 301 N. 2nd Street, St. Charles, MO 63301 | 2017-03-07 |
| 1457807067 | Angela Thro | Occupational Therapist | 3489 Boschertown Road, Saint Charles, MO 63301 | 2016-09-01 |
| 1487060570 | Missouri Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 2100 1st Capitol Dr, St. Charles, MO 63301 | 2014-07-09 |
| 1114337102 | Nucrown,inc. | Optometrist | 1910 First Capital Drive, St. Charles, MO 63301 | 2014-04-30 |
| 1780922476 | Kristen James | Counselor | 120 1st Capitol Dr Ste 5, Saint Charles, MO 63301 | 2013-01-30 |
| Find all providers in zip 63301 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851927644 | Donnan Assisting LLC | Physician Assistant | 36 Highland Dr, Saint Charles, MO 63303-4023 | 2020-03-12 |
| 1922646843 | Jennifer Lynn Donnan | Physician Assistant | 36 Highland Dr, Saint Charles, MO 63303-4023 | 2019-12-11 |
| 1235163635 | Heather Ann Schmitz | Physician Assistant | 400 1st Capitol Dr, Suite 307, Saint Charles, MO 63301-2880 | 2006-07-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184259079 | Dustin Edward Hemker | Physician Assistant | 937 Blake Ct, Saint Peters, MO 63376-5527 | 2020-03-11 |
| 1730669169 | Hannah Eagleburger | Physician Assistant | 4321 Wornall Rd, Ste 530, Kansas City, MO 64111 | 2018-08-15 |
| 1770073587 | Ashton Marie Roberts | Physician Assistant | 1 Hospital Dr # Dc077.00, Columbia, MO 65212-1000 | 2018-05-16 |
| 1295257285 | Katelynn Elizabeth Austin | Physician Assistant | 3250 Gordonville Rd Ste 384, Cape Girardeau, MO 63703-5095 | 2017-07-11 |
| 1407214364 | Kathryn Rebecca Bachman | Physician Assistant | 226 S Woods Mill Rd Ste 35w, Chesterfield, MO 63017-3442 | 2016-02-08 |
| 1699148429 | Michael Farrell | Physician Assistant | 7827 Highway N Ste 104, O Fallon, MO 63368-6704 | 2015-11-02 |
| 1427441492 | Cornerstone First Assisting | Physician Assistant | 267 Countryshire Dr, Lake St Louis, MO 63367-5823 | 2015-03-14 |
| 1205232915 | Pa Staffing LLC | Physician Assistant | 408 Ballwin Ave, Ballwin, MO 63021-5213 | 2014-11-06 |
| 1568702090 | Jamie Lyn Mertz | Physician Assistant | 9423 N Wayne Ct, Kansas City, MO 64155-2999 | 2013-02-20 |
| 1245586536 | Jeb Medical LLC | Physician Assistant | 1215 Clay St, Kansas City, MO 64116-4026 | 2012-07-24 |
| Find all providers with the same taxonomy | ||||
| City | SAINT CHARLES |
| Zip Code | 63301 |
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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.