KEVIN R MAHONEY (NPI# 1386745115) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386745115 |
| Entity Type | Individual |
| Full Name | KEVIN R MAHONEY |
| Credential | MD |
| Practice Address |
3635 Vista Ave St. Louis U., Trauma Surgery Div. - 3dt Saint Louis MO 63110-2539 |
| Practice Telephone | 3145778802 |
| Practice Fax Number | 3142685194 |
| Mailing Telephone | 3145778802 |
| Mailing Fax Number | 3142685194 |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2007-11-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RC0200X |
Internal Medicine Specialization: Critical Care Medicine |
43940 | WI | Allopathic & Osteopathic Physicians |
| N | 208600000X | Surgery | 43940 | WI | Allopathic & Osteopathic Physicians |
| Y | 2086S0127X |
Surgery Specialization: Trauma Surgery |
2007020558 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 34148300 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013154566 | Kevin Mahoney | Physician Assistant | 8411 Seneca Turnpike, New Hartford, NY 13413-4308 | 2009-01-20 |
| 1215384128 | Kevin Charles Mahoney | Speech-Language Pathologist | 861 Harold Pl, #205, Chula Vista, CA 91914-4553 | 2016-05-20 |
| 1730591355 | Kevin Francis Mahoney | Counselor | 1829 East Franklin Street, Building 600, Suite E-2, Chapel Hill, NC 27514 | 2014-06-02 |
| 1033558127 | Kevin Michael Mahoney | Obstetrics & Gynecology | 10510 Jefferson Ave, Ste D, Newport News, VA 23601-3102 | 2013-06-21 |
| 1912344151 | Kevin Jeffrey Mahoney | Podiatrist | 300 S Bruce St, Marshall, MN 56258-1934 | 2013-05-29 |
| 1124335997 | Kevin Mahoney | Physical Therapist | 1 Kettle Point Ave, East Providence, RI 02914-5375 | 2010-09-01 |
| 1164494241 | Kevin Robert Mahoney | Family Medicine | 120 N C Ave, Thermopolis, WY 82443-2410 | 2006-02-03 |
| Street Address |
3635 VISTA AVE ST. LOUIS U., TRAUMA SURGERY DIV. - 3DT |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63110-2539 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891790689 | Rajeswari Chintapalli | Anesthesiology | 3635 Vista Ave, Saint Louis, MO 63110-2539 | 2005-06-17 |
| 1932711389 | Breezy Summer Stanley | Nurse Practitioner | 3635 Vista Ave, Saint Louis, MO 63110-2539 | 2020-08-18 |
| 1235756842 | Trisha Ann Janis | Nurse Practitioner | 3635 Vista Ave, Saint Louis, MO 63110-2500 | 2020-06-30 |
| 1780207167 | Michelle Reale | Speech-Language Pathologist | 3635 Vista Ave, Saint Louis, MO 63110-2539 | 2020-05-20 |
| 1801418926 | Jason Adam Horowitz | Student in an Organized Health Care Education/Training Program | 3635 Vista Ave, Saint Louis, MO 63110-2539 | 2020-05-12 |
| 1255953378 | Luke Andrew Momper | Student in an Organized Health Care Education/Training Program | 3635 Vista Ave, Saint Louis, MO 63110-2539 | 2020-05-12 |
| 1063034197 | Tyler Daniel Ragsdale | Student in an Organized Health Care Education/Training Program | 3635 Vista Ave, Saint Louis, MO 63110-2539 | 2020-05-12 |
| 1417579541 | Kelyn N Pittman | Student in an Organized Health Care Education/Training Program | 3635 Vista Ave, Saint Louis, MO 63110-2539 | 2020-05-12 |
| 1881216901 | Purav Sudhir Brahmbhatt | Student in an Organized Health Care Education/Training Program | 3635 Vista Ave, Saint Louis, MO 63110-2539 | 2020-05-12 |
| 1578185989 | Feras Kaid | Radiologic Technologist | 3635 Vista Ave, Saint Louis, MO 63110-2539 | 2020-05-08 |
| 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 | 2086S0127X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Trauma Surgery |
| Trauma surgery is a recognized subspecialty of general surgery. Trauma surgeons are physicians who have completed a five-year general surgery residency and usually continue with a one to two year fellowship in trauma and/or surgical critical care, typically leading to additional board certification in surgical critical care. There is no trauma surgery board certification at this point. To obtain board certification in surgical critical care, a fellowship in surgical critical care or anesthesiology critical care must be completed during or after general surgery residency. |
| Notes: Source: American Board of Surgery, 2007 [1/1/2008: definition added, source added] Additional Resources: http://www.absurgery.org/. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861810111 | Abbie May Jensen | Surgery | 615 S New Ballas Rd Ste 560a, Saint Louis, MO 63141-8221 | 2014-04-03 |
| 1356561609 | St Louis University | Surgery | 3660 Vista Ave, Saint Louis, MO 63110-2540 | 2007-04-27 |
| 1669529657 | Stanley A. Sakabu | Surgery | 621 S New Ballas Rd, Suite 560-a, Saint Louis, MO 63141-8232 | 2007-01-04 |
| 1275637498 | Aaron Scifres | Surgery | 3635 Vista, 3rd Floor, Saint Louis, MO 63110 | 2006-09-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457521478 | Manuel Almendral Castasus | Surgery | 884 Woodsmill Road, Ttg Locum Tenens, Ballwin, MO 63011 | 2008-03-05 |
| 1205907359 | Dennis M Arce Md | Surgery | 6420 Prospect Ave Ste 311, Kansas City, MO 64132-4130 | 2006-11-12 |
| 1811087547 | Hillary Aa Chollet Md PC | Surgery | 6400 Prospect Ave Ste 338, Kansas City, MO 64132-1100 | 2006-10-13 |
| 1063468361 | Midwest Trauma Services, LLC | Surgery | 2330 East Meyer Blvd, T-207, Kansas City, MO 64132-4147 | 2006-05-26 |
| 1285684167 | Pascal Nyachowe | Surgery | 4320 Wornall Rd Ste 5320, Kansas City, MO 64111-5941 | 2006-05-11 |
| 1760934889 | Glenarm Acute Surgical Specialists LLC | Surgery | 2316 E Meyer Blvd, Kansas City, MO 64132-1136 | 2016-10-25 |
| 1194019968 | Kevin Clay Christian | Surgery | 3800 S National Ave, 4th Floor, Springfield, MO 65807-5209 | 2011-06-08 |
| 1316262793 | Jennifer Marie Laplante | Surgery | 400 1st Capitol Dr Ste 201, Saint Charles, MO 63301-2882 | 2010-03-29 |
| 1922236314 | Jeffrey Ray Simpson | Surgery | 2330 E Meyer Blvd, Ste 207, Kansas City, MO 64132-1132 | 2009-06-24 |
| 1457504722 | Leo Andrew Osifuye Benedict | Surgery | 4320 Wornall Rd Ste 530, Kansas City, MO 64111 | 2008-10-29 |
| Find all providers with the same taxonomy | ||||
| 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.