DR. IVANA M VETTRAINO (NPI# 1417007428) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417007428 |
| Entity Type | Individual |
| Full Name | DR. IVANA M VETTRAINO |
| Credential | M.D. |
| Practice Address |
621 S New Ballas Rd Ste 2007b Saint Louis MO 63141 |
| Mailing Address |
621 S New Ballas Rd Ste 2007b Saint Louis MO 63141-8265 |
| Practice Telephone | 3149915000 |
| Practice Fax Number | 3149915035 |
| Mailing Telephone | 3149915000 |
| Mailing Fax Number | 3149915035 |
| Enumeration Date | 2007-01-11 |
| Last Update Date | 2018-10-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207V00000X | Obstetrics & Gynecology | 4301062868 | MI | Allopathic & Osteopathic Physicians |
| Y | 207VM0101X |
Obstetrics & Gynecology Specialization: Maternal & Fetal Medicine |
4301062868 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | MEDICARE GROUP | OB56025 | 01 |
| MI | 4735826 | 05 | |
| MI | BCBSM GROUP | OB56025 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 22255 Greenfield Rd, Suite 350, Southfield, MI 480753710 | 2488492710 | 2488495318 |
| Street Address |
621 S NEW BALLAS RD STE 2007B |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63141 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669465134 | Carolyn M. Martin | Obstetrics & Gynecology | 621 S New Ballas Rd Ste 2007b, Saint Louis, MO 63141-8265 | 2005-08-30 |
| 1952810129 | Mercy Clinic Maternal Fetal Medicine LLC | Obstetrics & Gynecology | 621 S New Ballas Rd Ste 2007b, Saint Louis, MO 63141-8265 | 2017-09-20 |
| 1235498114 | Alexandra Marie Edwards | Obstetrics & Gynecology | 621 S New Ballas Rd Ste 2007b, Saint Louis, MO 63141-8265 | 2012-05-11 |
| 1629202270 | Asal Fathian | Obstetrics & Gynecology | 621 S New Ballas Rd Ste 2007b, Saint Louis, MO 63141-8265 | 2009-05-12 |
| 1558532895 | Amanda M Hermann | Dietitian, Registered | 621 S New Ballas Rd Ste 2007b, Saint Louis, MO 63141-8265 | 2008-03-14 |
| 1316122476 | Michelle Silasi | Obstetrics & Gynecology | 621 S New Ballas Rd Ste 2007b, Saint Louis, MO 63141-8265 | 2008-01-08 |
| 1598716920 | Joseph Polcaro | Obstetrics & Gynecology | 621 S New Ballas Rd Ste 2007b, Saint Louis, MO 63141-8265 | 2006-05-12 |
| 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 | 207VM0101X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| Specialization | Maternal & Fetal Medicine |
| An obstetrician/gynecologist who cares for, or provides consultation on, patients with complications of pregnancy. This specialist has advanced knowledge of the obstetrical, medical and surgical complications of pregnancy and their effect on both the mother and the fetus. The specialist also possesses expertise in the most current diagnostic and treatment modalities used in the care of patients with complicated pregnancies. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699185652 | Samantha Mullan | Obstetrics & Gynecology | 6420 Clayton Rd Ste 2701, Saint Louis, MO 63117-1811 | 2014-04-30 |
| 1972526994 | Michael J Paul | Obstetrics & Gynecology | 3009 N Ballas Rd Ste 351c, Saint Louis, MO 63131-2324 | 2006-07-25 |
| 1386647345 | George A Macones | Obstetrics & Gynecology | 4901 Forest Park Ave Ste 710, Ste 710, Saint Louis, MO 63108-1402 | 2005-05-24 |
| 1952810129 | Mercy Clinic Maternal Fetal Medicine LLC | Obstetrics & Gynecology | 621 S New Ballas Rd Ste 2007b, Saint Louis, MO 63141-8265 | 2017-09-20 |
| 1205272341 | Katherine Mae Massa | Obstetrics & Gynecology | 4901 Forest Park Ave, Div Obgyn Mfm / Ultrasound, Ste 710, Saint Louis, MO 63108-1495 | 2013-05-16 |
| 1164786166 | Kia S Lannaman | Obstetrics & Gynecology | 1031 Bellevue Ave Ste 400, Saint Louis, MO 63117-1858 | 2012-06-25 |
| 1568728939 | Megan Elizabeth Foeller | Obstetrics & Gynecology | 4901 Forest Park Ave, Ste 710, Saint Louis, MO 63108-1495 | 2012-04-10 |
| 1841585809 | Michael Mckinley Dombrowski | Obstetrics & Gynecology | 4901 Forest Park Ave, Ste 710, Saint Louis, MO 63108-1495 | 2011-06-17 |
| 1689969743 | Nandini Raghuraman | Obstetrics & Gynecology | 4901 Forest Park Ave, Ste 710, Saint Louis, MO 63108-1495 | 2011-06-16 |
| 1891086211 | Yu Lin Lee | Obstetrics & Gynecology | 4921 Parkview Pl, Ste 5a, Saint Louis, MO 63110-1032 | 2011-04-20 |
| 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.