DR. THOMAS V CRADOCK (NPI# 1366521551) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366521551 |
| Entity Type | Individual |
| Full Name | DR. THOMAS V CRADOCK |
| Credential | MD |
| Practice Address |
621 S New Ballas Rd Suite 6018b Saint Louis MO 63141-8232 |
| Practice Telephone | 3142515940 |
| Mailing Telephone | 3142515940 |
| Enumeration Date | 2006-11-06 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0120X |
Surgery Specialization: Pediatric Surgery |
32102 | MO | Allopathic & Osteopathic Physicians |
| Street Address |
621 S NEW BALLAS RD SUITE 6018B |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63141-8232 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790788941 | Robert J Backer | Specialist | 621 S New Ballas Rd, Ste 297a, Saint Louis, MO 63141-8232 | 2005-05-23 |
| 1609362474 | Manesh Kumar Gangwani | Internal Medicine | 621 S New Ballas Rd, Saint Louis, MO 63141-8232 | 2018-07-05 |
| 1164918165 | Ayesha Farrukh | Internal Medicine | 621 S New Ballas Rd, Saint Louis, MO 63141-8232 | 2018-07-03 |
| 1720573769 | Chelsea Renee Drissell | Family Medicine | 621 S New Ballas Rd, Saint Louis, MO 63141 | 2018-06-22 |
| 1023502358 | Bryan Gabriel Acree | Internal Medicine | 621 S New Ballas Rd, Saint Louis, MO 63141-8232 | 2018-06-20 |
| 1700370996 | Kathryn Emily Harvey-feldewerth | Internal Medicine | 621 S New Ballas Rd, Saint Louis, MO 63141-8232 | 2018-06-20 |
| 1063906493 | Paul Pearson Panasiuk | Obstetrics & Gynecology | 621 S New Ballas Rd, Saint Louis, MO 63141-8232 | 2018-06-19 |
| 1558855056 | Jessica Jenkins | Obstetrics & Gynecology | 621 S New Ballas Rd, Saint Louis, MO 63141-8232 | 2018-06-18 |
| 1679067276 | Kristopher Vaughn Pullam | Family Medicine | 621 S New Ballas Rd, Saint Louis, MO 63141-8232 | 2018-06-18 |
| 1932693629 | Lawrence Andrew Rudolf | Family Medicine | 621 S New Ballas Rd, Saint Louis, MO 63141-8232 | 2018-06-18 |
| 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 | 2086S0120X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Pediatric Surgery |
| A surgeon with expertise in the management of surgical conditions in premature and newborn infants, children and adolescents. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649296948 | Patrick A Dillon | Surgery | 1 Childrens Pl Ste A, Ste A, Saint Louis, MO 63110-1002 | 2006-07-14 |
| 1386130102 | Pattamon Sutthatarn | Surgery | 1465 S Grand Blvd, Saint Louis, MO 63104-1003 | 2018-07-04 |
| 1336588326 | Nicole April Wilson | Surgery | 1 Childrens Pl, Saint Louis, MO 63110 | 2013-06-23 |
| 1740447200 | Gustavo Adolfo Villalona | Surgery | 1465 S Grand Blvd, Saint Louis, MO 63104-1003 | 2008-05-21 |
| 1669662714 | Kathryn Quitasol Bernabe | Surgery | 1 Childrens Pl, Ste A, Saint Louis, MO 63110-1002 | 2007-07-25 |
| 1710185392 | Jesse Daya Vrecenak | Surgery | 1 Childrens Pl Ste A, Ste A, Saint Louis, MO 63110-1002 | 2007-07-05 |
| 1417155383 | Colleen M. Fitzpatrick | Surgery | 1465 S Grand Blvd, Pediatric Surgery, Saint Louis, MO 63104-1003 | 2007-07-03 |
| 1861611493 | Saint Louis University | Surgery | 3660 Vista Ave, Saint Louis, MO 63110-2540 | 2007-04-24 |
| 1972682169 | Martin J Bell | Surgery | 621 S New Ballas Rd, Suite 6018b, Saint Louis, MO 63141-8232 | 2006-11-06 |
| 1457430969 | Charles E Coln | Surgery | 621 S New Ballas Rd, Suite 6018b, Saint Louis, MO 63141-8232 | 2006-11-03 |
| 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.