DR. KORY JOSHUA LAVINE (NPI# 1295990315) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1295990315 |
Entity Type | Individual |
Full Name | DR. KORY JOSHUA LAVINE |
Credential | MD |
Practice Address |
1020 N Mason Rd Ste 100 Ste 100 Saint Louis MO 63141-6300 |
Mailing Address |
660 S Euclid Ave C B 8086 Saint Louis MO 63110-1010 |
Practice Telephone | 3143621291 |
Practice Fax Number | 3143624278 |
Mailing Telephone | 3143621291 |
Mailing Fax Number | 3143624278 |
Enumeration Date | 2008-07-29 |
Last Update Date | 2018-01-24 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
2010008621 | MO | Allopathic & Osteopathic Physicians |
Y | 207RA0001X |
Internal Medicine Specialization: Advanced Heart Failure and Transplant Cardiology |
2010008621 | MO | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
IL | ENROLLED | 05 |
Street Address |
1020 N MASON RD STE 100 STE 100 |
City | SAINT LOUIS |
State | MO |
Zip Code | 63141-6300 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1811922768 | David Lloyd Brown | Internal Medicine | 1020 N Mason Rd Ste 100, Ste 100, Saint Louis, MO 63141-6300 | 2006-07-11 |
1750537395 | Nishath Quader | Internal Medicine | 1020 N Mason Rd Ste 100, Ste 100, Saint Louis, MO 63141-6300 | 2008-08-14 |
1922208552 | Justin Samuel Sadhu | Internal Medicine | 1020 N Mason Rd Ste 100, Ste 100, Saint Louis, MO 63141-6300 | 2007-07-22 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1679102842 | Noor Ramadan | Pharmacist | 628 North New Ballad Road, Suite A, Creve Coeur, MO 63141 | 2020-04-08 |
1497381206 | Washington University | Durable Medical Equipment & Medical Supplies | 1044 North Mason Road, Suite 110/210, St. Louis, MO 63141 | 2020-03-13 |
1154956498 | Ashleigh Clendenny | Physician Assistant | Mercy Hospital St. Louis, 615 S New Ballas Rd, St. Louis, MO 63141 | 2020-03-06 |
1801429410 | Emili Lou Haley | Registered Nurse | 650 Maryville Drive, St Louis, MO 63141 | 2020-02-21 |
1629553110 | Rebecca Kathleen Pike | Social Worker | West County Psychological Associates, 12125 Woodcrest Executive Drive #110, St. Louis, MO 63141 | 2018-10-01 |
1649756099 | River City Sedation Associates, LLC | Nurse Anesthetist, Certified Registered | 12855 N 40 Dr Ste 150, Saint Louis, MO 63141 | 2018-07-18 |
1205333952 | Ear Care and Hearing of St. Louis | Hearing Aid Equipment | 11630 Studt Ave Ste 210, Creve Coeur, MO 63141 | 2018-04-10 |
1659897486 | Erin Goodman | Physical Therapist | 10560 Old Olive St. Rd, Suite 100, Creve Coeur, MO 63141 | 2017-08-14 |
1093230450 | Center for Urologic Surgery LLC | Clinic/Center | 12855 N 40 Dr Ste 100, Saint Louis, MO 63141 | 2017-08-07 |
1871016105 | Jacob Farley Tanner | Specialist/Technologist | 1054 Town and Four Parkway Dr, Creve Coeur, MO 63141 | 2017-07-19 |
Find all providers in zip 63141 |
Taxonomy Code | 207RA0001X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Internal Medicine |
Specialization | Advanced Heart Failure and Transplant Cardiology |
Specialists in Advanced Heart Failure and Transplant Cardiology would participate in the inpatient and outpatient management of patients with advanced heart failure across the spectrum from consideration for high-risk cardiac surgery, cardiac transplantation, or mechanical circulatory support, to pre-and post-operative evaluation and management of patients with cardiac transplants and mechanical support devices, and end-of-life care for patients with end-stage heart failure. |
Notes: Source: American Board of Internal Medicine, www.abim.org [7/1/2015: new] |
City | SAINT LOUIS |
Zip Code | 63141 |
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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.