DR. DERYK L MCDOWELL (NPI# 1356486179) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356486179 |
| Entity Type | Individual |
| Full Name | DR. DERYK L MCDOWELL |
| Credential | M.D. |
| Practice Address |
625 S New Ballas Rd Suite 2030 Saint Louis MO 63141-8253 |
| Mailing Address |
136 Reavis Pl Webster Groves MO 63119-4034 |
| Practice Telephone | 3142511700 |
| Practice Fax Number | 3142511701 |
| Mailing Telephone | 3149613498 |
| Enumeration Date | 2007-02-20 |
| Last Update Date | 2015-01-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
2005006002 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 1356486179 | 05 | |
| MO | RAILROAD MEDICARE | P00776606 | 01 |
| DEA | BM8927014 | 01 |
| Street Address |
625 S NEW BALLAS RD SUITE 2030 |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63141-8253 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295738201 | Louis P Stickley | Internal Medicine | 625 S New Ballas Rd, Ste 2030, Saint Louis, MO 63141-8253 | 2005-05-23 |
| 1275078339 | Anne Elizabeth Robinson | Physician Assistant | 625 S New Ballas Rd, Suite R-7040, Saint Louis, MO 63141-8253 | 2016-12-28 |
| 1548705601 | Renee Suzanne Kertz | Physician Assistant | 625 S New Ballas Rd, Suite R-7040, Saint Louis, MO 63141-8253 | 2016-12-28 |
| 1407399736 | Nicole Michelle Rohr | Nurse Practitioner | 625 S New Ballas Rd, Suite 2015, Saint Louis, MO 63141-8253 | 2016-11-18 |
| 1437691540 | Danielle Getsee | Physician Assistant | 625 S New Ballas Rd, Saint Louis, MO 63141-8253 | 2016-11-07 |
| 1093165946 | Catherine Ann Vasilevski | Internal Medicine | 625 S New Ballas Rd, Saint Louis, MO 63141-8253 | 2016-06-21 |
| 1932557964 | Leah Jones | Nurse Practitioner | 625 S New Ballas Rd, Saint Louis, MO 63141-8253 | 2016-05-31 |
| 1154782340 | Mercy Hospital St. Louis Professional Surgical Services LLC | Surgery | 625 S New Ballas Rd, Saint Louis, MO 63141-8253 | 2016-03-15 |
| 1568848414 | Kyle Hoff | Physician Assistant | 625 S New Ballas Rd, Suite R7040, Saint Louis, MO 63141-8253 | 2015-08-03 |
| 1841613205 | Nora Elizabeth O'brien | Nurse Practitioner | 625 S New Ballas Rd, Suite 20130, Saint Louis, MO 63141-8253 | 2014-01-21 |
| Find all providers in the same location | ||||
| 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 | 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 |
|---|---|---|---|---|
| 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 |
| 1982999462 | Philip L Mar | Internal Medicine | 3635 Vista Ave Fl 15, Saint Louis, MO 63110-2539 | 2011-06-13 |
| 1255644191 | Rugheed Ghadban | Internal Medicine | 1402 S Grand Blvd Ste 260, Saint Louis, MO 63104-1004 | 2010-07-20 |
| 1962727404 | Tyson E Turner | Internal Medicine | 625 S New Ballas Rd Ste 2015, Saint Louis, MO 63141 | 2010-03-27 |
| 1649468786 | Midwest Cardiovascular, Inc. | Internal Medicine | 1031 Bellevue Ave Ste 200, Saint Louis, MO 63117-1856 | 2007-10-12 |
| 1124225347 | Pradeep Aaron Chandra | Internal Medicine | 11155 Dunn Rd Ste 304e, Saint Louis, MO 63136-6111 | 2007-06-29 |
| 1699856443 | Miguel Angel Paniagua | Internal Medicine | 12414 Lusher Rd, Saint Louis, MO 63138-1456 | 2006-10-18 |
| 1235147109 | Jerome D Cohen | Internal Medicine | 8138 Westmoreland Ave, Provider Enrollment, Saint Louis, MO 63105-3731 | 2006-08-04 |
| Find all providers in SAINT LOUIS | ||||
| 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.