ST LOUIS UNIVERSITY (NPI# 1376769380) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376769380 |
| Entity Type | Organization |
| Organization Name | ST LOUIS UNIVERSITY |
| Other Organization Name | SLUCARE DEPT OF INTERNAL MEDICINE-GERIATRICS |
| Practice Address |
3660 Vista Ave Saint Louis MO 63110-2540 |
| Mailing Address |
1831 Chestnut St Ste 650 Saint Louis MO 63103-2236 |
| Practice Telephone | 3149776055 |
| Mailing Telephone | 3149776828 |
| Enumeration Date | 2007-04-18 |
| Last Update Date | 2019-06-20 |
| Authorized Official Name | ALYCE LANXON (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 3149776828 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RG0300X |
Internal Medicine Specialization: Geriatric Medicine |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| SLUCare Dept of Internal Medicine-Geriatrics | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487869863 | St Louis University | Eyewear Supplier (Equipment, not the service) | 1755 South Grand, St Louis, MO 63104 | 2007-05-11 |
| 1194892463 | St Louis University | Orthopaedic Surgery | 1831 Chestnut St Ste 650, Saint Louis, MO 63103 | 2006-11-29 |
| 1093894842 | St Louis University | Internal Medicine | 10 Franklin, Washington, MO 63090 | 2006-11-03 |
| 1417035759 | St Louis University | Audiologist | 3750 Lindell, St Louis, MO 63108 | 2006-11-02 |
| 1992778237 | St Louis University | Urology | 3655 Vista Ave, Saint Louis, MO 63110-2539 | 2006-02-08 |
| 1164495412 | St Louis University | Pathology | 1402 South Grand, St Louis, MO 63104 | 2006-02-08 |
| 1801869136 | St Louis University | Psychiatry & Neurology | 1438 S Grand Blvd, Saint Louis, MO 63104-1027 | 2006-02-08 |
| 1740253095 | St Louis University | Dermatology | 1755 S Grand Blvd, Saint Louis, MO 63104-1540 | 2006-02-08 |
| 1184266413 | St Louis University | Pediatrics | 1465 S Grand Blvd, Saint Louis, MO 63104-1003 | 2019-10-08 |
| 1184908865 | St Louis University | Urology | 1465 S Grand Blvd, Saint Louis, MO 63104-1003 | 2011-09-29 |
| Street Address |
3660 VISTA AVE |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63110-2540 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871582692 | Alan P K Wild | Otolaryngology | 3660 Vista Ave, Ste. 312, Saint Louis, MO 63110 | 2005-10-14 |
| 1922627207 | Emily Bayliss Worrall | Student in an Organized Health Care Education/Training Program | 3660 Vista Ave, Saint Louis, MO 63110-2540 | 2020-04-16 |
| 1508485988 | Jackson Jeffrey Meland | Student in an Organized Health Care Education/Training Program | 3660 Vista Ave, Saint Louis, MO 63110-2540 | 2020-04-15 |
| 1316566748 | Katherine Elizabeth Oberhelman | Student in an Organized Health Care Education/Training Program | 3660 Vista Ave, Saint Louis, MO 63110-2540 | 2020-04-15 |
| 1063031664 | Elizabeth Jane De Quetteville Robin | Student in an Organized Health Care Education/Training Program | 3660 Vista Ave, Saint Louis, MO 63110-2540 | 2020-04-14 |
| 1053930586 | Tim Brotherton Jr. | Student in an Organized Health Care Education/Training Program | 3660 Vista Ave, Saint Louis, MO 63110-2540 | 2020-04-14 |
| 1285253328 | Eugene Chiemeka Nwankwo Jr. | Student in an Organized Health Care Education/Training Program | 3660 Vista Ave, Saint Louis, MO 63110-2540 | 2020-04-09 |
| 1124647318 | Christian Hendrix | Student in an Organized Health Care Education/Training Program | 3660 Vista Ave, Saint Louis, MO 63110-2540 | 2020-04-08 |
| 1851920730 | Kellen J Smutz | Student in an Organized Health Care Education/Training Program | 3660 Vista Ave, Saint Louis, MO 63110-2540 | 2020-04-03 |
| 1487283172 | Abhinav Reddy | Student in an Organized Health Care Education/Training Program | 3660 Vista Ave, Saint Louis, MO 63110-2540 | 2020-04-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659971992 | Carrie Ellen Smith | Nurse Practitioner | Mailstop 90-00-174, One Barnes-jewish Plaza, St. Louis, MO 63110 | 2020-10-27 |
| 1881210466 | Michelle Amanda Freilich | Internal Medicine | Barnes-jewish Plaza, St. Louis, MO 63110 | 2020-06-19 |
| 1245856046 | Jeevin Shahi | Radiology | 3685 Vista Avenue, Center for Radiation Medicine, St. Louis, MO 63110 | 2020-06-18 |
| 1497371314 | Wilson Eduardo Rodriguez | Student in an Organized Health Care Education/Training Program | 1008 S. Spring, St Louis, MO 63110 | 2020-06-17 |
| 1578184065 | Kathryn Kay Lindsay | Registered Nurse | Saint Louis University Dept of Surgery, 3635 Vista Ave 3dt, St Louis, MO 63110 | 2020-05-06 |
| 1881232700 | Ashley Diane Pace | Nurse Practitioner | 1 Parkview Place, Shoenberg 6900, St. Louis, MO 63110 | 2019-12-11 |
| 1619520418 | Krithika Damodar Shenoy | Pathology | 660 Euclid Avenue, One Barnes Jewish Hospital Plaza, St. Louis, MO 63110 | 2019-07-20 |
| 1467912550 | Ian Ferguson | Dermatology | 660 S Euclid Ave., Cb 8123, St. Louis, MO 63110 | 2019-03-23 |
| 1760978688 | Ihab Hassanieh | Student in an Organized Health Care Education/Training Program | 33660 Vista Ave, St. Louis, MO 63110 | 2018-07-03 |
| 1336634500 | Martin K Mwangi | Pediatrics | 1 Childrens Place, 3s34, St. Louis, M, MO 63110 | 2018-06-28 |
| Find all providers in zip 63110 | ||||
| Taxonomy Code | 207RG0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Geriatric Medicine |
| An internist who has special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes and the hospital. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://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 |
|---|---|---|---|---|
| 1023592946 | Institute of Medicine LLC | Internal Medicine | 6824 Balson Ave, Saint Louis, MO 63143-2603 | 2018-09-17 |
| 1104235241 | Generation Clinical Partners LLC | Internal Medicine | 11500 Olive Blvd Ste 235, Saint Louis, MO 63141-7141 | 2014-08-02 |
| 1558563890 | Hassan Dawoud Elsiddig | Internal Medicine | 3660 Vista Ave # 204, Saint Louis, MO 63110-2540 | 2007-05-31 |
| 1871795104 | Shehla Sadiq | Internal Medicine | 3660 Vista Ave # 2104, Saint Louis, MO 63110-2540 | 2007-05-31 |
| 1184755118 | Geromed, LLC | Internal Medicine | 4675 S Grand Blvd, Saint Louis, MO 63111-1462 | 2007-03-09 |
| 1851446207 | Poonam M Jain | Internal Medicine | 1 Meadow Acres, Saint Louis, MO 63124-1460 | 2007-01-24 |
| 1154484673 | Miriam B Rodin | Internal Medicine | 1402 S Grand Blvd Rm 238, Division of Geriatric Medicine, Saint Louis, MO 63104-1004 | 2006-12-18 |
| 1992815906 | Susan Robinson Reeds | Internal Medicine | 8 Millstone Campus Dr, Ste 1500, Saint Louis, MO 63146-5766 | 2006-08-30 |
| 1780602417 | Monique Marie Williams | Internal Medicine | 969 N Mason Rd Ste 145, Saint Louis, MO 63141 | 2006-07-18 |
| 1124073630 | Rafi Thomas Kevorkian | Internal Medicine | 522 N New Ballas Rd Ste 317, Saint Louis, MO 63141-6840 | 2006-05-23 |
| Find all providers in SAINT LOUIS | ||||
| City | SAINT LOUIS |
| Zip Code | 63110 |
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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.