SSM CARDINAL GLENNON CHILDREN'S HOSPITAL (NPI# 1356412308) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1356412308 |
Entity Type | Organization |
Organization Name | SSM CARDINAL GLENNON CHILDREN'S HOSPITAL |
Other Organization Name | SSM HEALTH CARDINAL GLENNON PEDIATRICS |
Practice Address |
132 Professional Pkwy Troy MO 63379-2823 |
Mailing Address |
1195 Corporate Lake Dr Saint Louis MO 63132-1716 |
Practice Telephone | 6364625437 |
Mailing Telephone | 3149893524 |
Enumeration Date | 2006-11-13 |
Last Update Date | 2019-07-19 |
Authorized Official Name | TIM BULLER (REGIONAL CFO - FINANCIAL STRATEGY) |
Authorized Official Telephone | 3149892173 |
Is Organization Subpart | Y |
Parent Organization Name | SSM HEALTH CARE CORPORATION |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 261QR1300X |
Clinic/Center Specialization: Rural Health |
Ambulatory Health Care Facilities | ||
Y | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MO | 505459107 | 05 |
Other Name | Type Code |
---|---|
SSM Glennon Care Pediatrics - Troy | Doing Business As Name - Organization |
SSM Glennon Care Pediatrics - Troy | Other Name - Individual/Organization |
SSM Health Cardinal Glennon Pediatrics | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1962573212 | Ssm Cardinal Glennon Children's Hospital | Clinic/Center | 511 Ashland Ave, Warrenton, MO 63383-1065 | 2006-11-10 |
1699087601 | Ssm Cardinal Glennon Children's Hospital | General Acute Care Hospital | 1465 S Grand Blvd, Diet Office, Saint Louis, MO 63104-1003 | 2010-07-07 |
1669644456 | Ssm Cardinal Glennon Children's Hospital | Clinic/Center | 1475 Kisker Rd, Suite 120, Saint Charles, MO 63304-8781 | 2008-04-01 |
1508935891 | Ssm Cardinal Glennon Children's Hospital | General Acute Care Hospital | 1465 S Grand Blvd, Saint Louis, MO 63104-1003 | 2006-11-08 |
1811074651 | Ssm Cardinal Glennon Children's Hospital | Clinic/Center | 12700 Southfork Rd, Saint Louis, MO 63128-3201 | 2006-11-01 |
Entity Type | Entity Name | Entity Address |
---|---|---|
System for Award Management (SAM) Entities | SSM CARDINAL GLENNON CHILDREN'S HOSPITAL | 1465 S Grand Blvd, Saint Louis, MO 63104-1003 |
Street Address |
132 PROFESSIONAL PKWY |
City | TROY |
State | MO |
Zip Code | 63379-2823 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1295909992 | Michelle Lynn Phillips | Pediatrics | 132 Professional Pkwy, Troy, MO 63379-2823 | 2008-04-15 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1336746601 | Cathleen Burks | Counselor | 384 Rockport Dr, Troy, MO 63379 | 2020-10-08 |
1851818058 | Sarah Tippit | Occupational Therapist | 39 Cattail Pl, Troy, MO 63379 | 2017-08-28 |
1104360239 | Lori Seulean LLC | Counselor | 410 Sydna Ct, Troy, MO 63379 | 2016-12-08 |
1659827210 | Elisabeth Marie Nation | Physical Therapist | 722 N Hwy 47 Suite A, Warrenton, MO 63379 | 2016-09-01 |
1598054587 | Janice Ann Mills | Counselor | 1385 Creech School Road, Troy, MO 63379 | 2011-03-31 |
1437450871 | All Family Chiropractic LLC | Chiropractor | 9 Plaza, Troy, MO 63379 | 2010-11-16 |
1063713246 | Troy Family Dentistry, LLC | Dentist | 128 Professional Parkway, Troy, MO 63379 | 2010-11-04 |
1437478476 | Jennifer G Ray | Pediatrics | 164 Professional Pkwy, Troy, MO 63379 | 2010-05-28 |
1184868523 | Troy Residential, LLC | Assisted Living Facility | 159 Professional Parkway, Troy, MO 63379 | 2009-04-29 |
1639356793 | Susan Kaye Galloway | Counselor | 104 Mound, Troy, MO 63379 | 2008-01-30 |
Find all providers in zip 63379 |
Taxonomy Code | 208000000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Pediatrics |
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1437478476 | Jennifer G Ray | Pediatrics | 164 Professional Pkwy, Troy, MO 63379 | 2010-05-28 |
1982854840 | Sachin K Shah | Pediatrics | 1007 Alameda Blvd, Troy, MI 48085-6736 | 2008-09-26 |
1962665869 | Jonathan Lauter | Pediatrics | 1800 W Big Beaver Rd Ste 200, Troy, MI 48084-3545 | 2008-07-10 |
1104086461 | Elizabeth N Dawson | Pediatrics | 1300 United States Highway 231 South, Troy, AL 36081 | 2008-06-11 |
1902087380 | Christina Zanakis-tempelis | Pediatrics | 111 Scouting Circle, Troy, AL 36081 | 2007-11-14 |
1932288552 | Annamalai Muthiah | Pediatrics | 195 5th Avenue, Troy, NY 12180 | 2006-11-03 |
1356440572 | Center for Pediatric & Adolescent Medicine | Pediatrics | 2100 W Big Beaver, Ste 110, Troy, MI 48084 | 2006-09-22 |
1194824805 | Norma Iringan Pattugalan | Pediatrics | 1405 Stonycreek Rd, Troy, OH 45373 | 2006-09-21 |
1174591549 | Majda A Hannish | Pediatrics | 2100 W Big Beaver Rd, Ste 110, Troy, MI 48084 | 2006-03-10 |
1316922271 | Mary D Oshea | Pediatrics | 3270 W Big Beaver Rd, Suite 400, Troy, MI 48084-2901 | 2005-12-13 |
Find all providers in TROY |
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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.