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).
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 |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
33875 | MO | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MO | 200920817 | 05 | |
IL | IDPA | 7480467052 | 01 |
RR MCR | P00320613 | 01 |
Street Address |
1225 GRAHAM RD STE 2310C |
City | FLORISSANT |
State | MO |
Zip Code | 63031-8012 |
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 |
Find all providers in the same location |
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 |
Find all providers in zip 63031 |
Taxonomy Code | 207RC0000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Internal Medicine |
Specialization | Cardiovascular Disease |
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. |
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 |
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 |
Find all providers with the same taxonomy |
City | FLORISSANT |
Zip Code | 63031 |
Please comment or provide details below to improve the information on DR. ANTONIO R PENILLA.
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.