ABID NISAR (NPI# 1245375567) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245375567 |
| Entity Type | Individual |
| Full Name | ABID NISAR |
| Credential | MD |
| Practice Address |
2730 S Saint Peters Pkwy Ste 103 Saint Peters MO 63303-5677 |
| Practice Telephone | 3149601052 |
| Practice Fax Number | 6366850021 |
| Mailing Telephone | 3149601052 |
| Mailing Fax Number | 6366850021 |
| Enumeration Date | 2007-02-21 |
| Last Update Date | 2020-05-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | R1D36 | MO | Allopathic & Osteopathic Physicians |
| N | 207R00000X | Internal Medicine | 036069763 | IL | Allopathic & Osteopathic Physicians |
| N | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
036069763 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | RR MEDICARE | P00204269 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2044 Madison Ave Ste 28, Granite City, IL 620404661 | 6184519953 |
| Street Address |
2730 S SAINT PETERS PKWY STE 103 |
| City | SAINT PETERS |
| State | MO |
| Zip Code | 63303-5677 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083214787 | Michael Frederick | Pharmacist | 2855 Veterans Memorial Parkway, (pharmacy), Saint Charles, MO 63303 | 2020-10-30 |
| 1710525639 | Cheryl Ann O'dell | Pharmacist | Schnucks Pharmacy, 60 Harvester Square, St Charles, MO 63303 | 2019-12-11 |
| 1255821302 | Melinda R Winfield | Nurse Practitioner | 1313 Park Ct, Saint Charles, MO 63303 | 2018-05-15 |
| 1467904839 | Heather Lilledahl | Speech-Language Pathologist | 2800 Old Muegge Road, Saint Charles, MO 63303 | 2016-11-01 |
| 1437608312 | Preferred Family Healthcare | Counselor | 1559 Old S. River Road, St.charles, MO 63303 | 2016-10-03 |
| 1487109146 | Annette Patricia Davenport | Nurse Practitioner | 1551 Wall Street, Logistics Health Inc, Suite 100, Saint Charles, MO 63303 | 2016-08-23 |
| 1053762328 | Sarah Biondo | Speech-Language Pathologist | 7204 Fountainview Circle, Ofallon, MO 63303 | 2016-06-28 |
| 1710331335 | Lindsey Ann Eilers | Counselor | 1570 South Main, Saint Charles, MO 63303 | 2016-04-20 |
| 1174914600 | Jacquelyn Michele Miller | Pharmacy Technician | 3881 Mexico Road, Saint Charles, MO 63303 | 2015-02-05 |
| 1164838132 | Francelle Denise Neal | Counselor | 2480 Executive Dr Ste 111, Saint Charles, MO 63303 | 2014-07-10 |
| Find all providers in zip 63303 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689038077 | Deanna Justine Bajala | Family Medicine | 6994 Mexico Rd, Saint Peters, MO 63376-1512 | 2016-04-11 |
| 1588079727 | Michael P Schachter | Family Medicine | 4800 Mexico Rd Ste 102, Saint Peters, MO 63376-1666 | 2014-06-26 |
| 1760771869 | Osteopathic Solutions LLC | Family Medicine | 8069 Mexico Rd, Saint Peters, MO 63376-1148 | 2011-03-30 |
| 1114991643 | Richard J Leahy | Family Medicine | 1600 Heritage Lndg, Ste 215, Saint Peters, MO 63303-8489 | 2006-02-13 |
| 1962496695 | Jeffrey A Atkins | Family Medicine | 107 Piper Hill Dr Ste 100, Saint Peters, MO 63376-1651 | 2005-09-08 |
| 1285627331 | Steven Michael Radel | Family Medicine | 201 Bjc Saint Peters Dr Ste 200, Saint Peters, MO 63376-3091 | 2005-08-24 |
| 1457958837 | Ashish Javer | Family Medicine | 4601 Executive Centre Pkwy Ste 300, Saint Peters, MO 63376-1685 | 2020-10-08 |
| 1457972044 | Mo Biologics Inc | Family Medicine | 4601 Executive Centre Pkwy Ste 300, Saint Peters, MO 63376-1685 | 2020-05-05 |
| 1841636354 | Ngozidilenna Ada Wilkins | Family Medicine | 201 Bjc Saint Peters Dr Ste 200, Saint Peters, MO 63376-3386 | 2013-05-13 |
| 1235431198 | Samara Epps Mcelroy | Family Medicine | 201 Bjc Saint Peters Dr Ste 200, Saint Peters, MO 63376-3386 | 2010-11-29 |
| Find all providers in SAINT PETERS | ||||
| City | SAINT PETERS |
| Zip Code | 63303 |
Please comment or provide details below to improve the information on ABID NISAR.
| 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.