SSM CARDINAL GLENNON CHILDREN'S HOSPITAL


Address: 132 Professional Pkwy, Troy, MO 63379-2823
Phone: 6364625437

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).

Provider Overview

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

Taxonomy

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

Other Provider Identifier

State Issuer Identifier Type Code
MO 505459107 05

Other Provider/Organization Names

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

Other Provider IDs and Locations

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

Other Data Sources

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

Office Location

Street Address 132 PROFESSIONAL PKWY
City TROY
State MO
Zip Code 63379-2823

Providers in the same location

NPI Name Taxonomy Address Enumeration
1295909992 Michelle Lynn Phillips Pediatrics 132 Professional Pkwy, Troy, MO 63379-2823 2008-04-15

Providers in the same zip code

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 Information

Taxonomy Code 208000000X
Grouping Allopathic & Osteopathic Physicians
Classification Pediatrics

Taxonomy Definition

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.

Providers in the same taxonomy and city

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

Competitor

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City TROY
Zip Code 63379

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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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