DR. ANTONIO R PENILLA


Address: 1225 Graham Rd, Ste 2310c, Florissant, MO 63031-8012
Phone: 3149536300

DR. ANTONIO R PENILLA (NPI# 1265431399) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1265431399
Entity Type Individual
Full Name DR. ANTONIO R PENILLA
Credential M.D.
Practice Address 1225 Graham Rd
Ste 2310c
Florissant
MO 63031-8012
Mailing Address 670 Mason Ridge Center Dr
Ste. 300
Saint Louis
MO 63141-8573
Practice Telephone 3149536300
Practice Fax Number 3149536309
Mailing Telephone 3149536300
Mailing Fax Number 3149536309
Enumeration Date 2005-07-20
Last Update Date 2013-01-30
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207RC0000X Internal Medicine
Specialization: Cardiovascular Disease
33875 MO Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
MO 200920817 05
IL IDPA 7480467052 01
RR MCR P00320613 01

Office Location

Street Address 1225 GRAHAM RD
STE 2310C
City FLORISSANT
State MO
Zip Code 63031-8012

Providers in the same location

NPI Name Taxonomy Address Enumeration
1912549452 Erica Frazier Social Worker 1225 Graham Rd, Florissant, MO 63031-8012 2019-10-16
1275174088 Pamela Wooten Registered Nurse 1225 Graham Rd, Florissant, MO 63031-8012 2019-10-02
1700357647 John A Powers Nurse Practitioner 1225 Graham Rd, Florissant, MO 63031-8012 2018-12-17
1922454719 Jenna O'shea Nurse Practitioner 1225 Graham Rd, Ste 1340c, Florissant, MO 63031-8012 2016-05-11
1093135980 Daniel Zwilling Physician Assistant 1225 Graham Rd, Florissant, MO 63031-8012 2014-04-18
1356769012 Lindsay Riedl Jaeger Pediatrics 1225 Graham Rd, Florissant, MO 63031-8012 2014-03-31
1942627823 Kathryn A Spectorsky Pediatrics 1225 Graham Rd, Florissant, MO 63031-8012 2014-03-27
1124459730 Javda Miasha Wilson Nurse Practitioner 1225 Graham Rd, Florissant, MO 63031-8012 2013-12-06
1013358100 Laura M Gramolino Nurse Practitioner 1225 Graham Rd, Florissant, MO 63031-8012 2013-07-17
1316381270 Ritu L Zei Pediatrics 1225 Graham Rd, Florissant, MO 63031-8012 2013-04-23
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1528550019 A Precious Home Care Solution Cds LLC Home Health 2367 Periwinkle Court, Florisant, MO 63031 2018-05-31
1932625415 Haven of Grooming Specialist 51 Florissant Oaks Shop Center, Florissant, MO 63031 2017-08-16
1841696648 Deandra's Angels Home Care Home Health 1985 Lindsay Lane, Florissant, MO 63031 2014-11-06
1871907378 Daniel Joseph Watson Ophthalmology 900 N Highway 67 St, Florissant, MO 63031 2014-06-12
1124449954 Edgar Micere Occupational Therapy Assistant 1 Paul Place Ct, Florissant, MO 63031 2013-12-20
1699019190 Dushanas Touch of Love Transportation L.l.c Non-emergency Medical Transport (VAN) 3011 Oriental Dr, Florissant, MO 63031 2012-11-21
1790038321 Pleasant Solutions Home Health Care,llc Community Based Residential Treatment Facility, Mental Illness 100 Rue St. Francios Suite 107, Saint Louis, MO 63031 2012-10-19
1114279460 Access Dental & Dentures LLC Dentist 565 Howdershell Rd, Florissant, MO 63031 2012-10-11
1982980843 Lauren Heimberger Pharmacist 15390 New Halls Ferry, Florissant, MO 63031 2011-10-24
1578878732 North County Adult Center LLC Registered Nurse 500 Greenway Manor Dr, Florissant, MO 63031 2010-08-12
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Taxonomy Information

Taxonomy Code 207RC0000X
Grouping Allopathic & Osteopathic Physicians
Classification Internal Medicine
Specialization Cardiovascular Disease

Taxonomy Definition

An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.
Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source]
- Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1346342581 Chandra S Kaup Internal Medicine 1224 Graham Road, Ste 2006, Florissant, MO 63031-8078 2006-09-01
1235157876 Yogesh R Patel Internal Medicine 1225 Graham Rd Ste C-2310, Florissant, MO 63031-8023 2006-07-18
1023218807 Rita Mukerji Internal Medicine 1225 Graham Rd Ste C-2310, Florissant, MO 63031 2007-07-20
1417155672 Deepak Koul Internal Medicine 1225 Graham Rd, Bld C, Ste 2310, Florissant, MO 63031-8012 2007-07-10
1821131806 Fairview Heights Medical Group Sc Internal Medicine 201 Dunn Rd, Florissant, MO 63031-7928 2007-02-15
1326187352 Matthew Alan Fraley Internal Medicine 1225 Graham Rd Ste C-2310, Florissant, MO 63031-8023 2007-02-06
1467532267 Walter Aaron Dimmitt Internal Medicine 1225 Graham Rd Ste C-2310, Florissant, MO 63031-8023 2006-10-16
1699879122 North County Internists, LLC Internal Medicine 4585 Washington St, Suite A1, Florissant, MO 63033-5858 2006-09-13
1366441339 Erica L. Uppstrom Internal Medicine 1225 Graham Rd, Ste 2310c, Florissant, MO 63031-8012 2005-07-20

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1689128019 Midwest Heart Institute Internal Medicine 1439 Us Highway 61, Ste A, Festus, MO 63028-4153 2016-08-15
1477984292 Robert A. Brinkman, M.d., LLC. Internal Medicine 1040 N Mason Rd Ste 211, Creve Coeur, MO 63141 2013-12-04
1528407822 Justin Patrick Sheehy Internal Medicine 4401 Wornall Rd Fl 9, Kansas City, MO 64111-3220 2013-06-19
1952643520 Meritas Health Corporation Internal Medicine 5501 Nw 62nd Ter Ste 201, Kansas City, MO 64151-2408 2013-03-21
1043557150 Ronald Nathan Riner Internal Medicine 9847 Waterbury Drive, St. Louis, MO 63124 2013-01-09
1427315423 Paul Larsen Internal Medicine 1027 Bellevue Ave Ste 200, Saint Louis, MO 63117-1851 2012-04-13
1275899718 Bradley Carl Witbrodt Internal Medicine 3023 N Ballas Rd Ste 200, Saint Louis, MO 63131-2330 2012-04-10
1194004952 Jad Raffoul Internal Medicine 1402 S Grand Blvd Fl 14, Saint Louis, MO 63104-1004 2011-08-11
1376839894 Chetan P Huded Internal Medicine 5844 Nw Barry Rd Ste 230, Kansas City, MO 64154-1421 2011-06-22
1982999462 Philip L Mar Internal Medicine 3635 Vista Ave Fl 15, Saint Louis, MO 63110-2539 2011-06-13
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Competitor

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City FLORISSANT
Zip Code 63031

Improve Information

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Dataset Information

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.

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