ROUBA GHOUSSOUB MD LLC (NPI# 1417349234) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1417349234 |
Entity Type | Organization |
Organization Name | ROUBA GHOUSSOUB MD LLC |
Practice Address |
1400 Us Highway 61 G30 Festus MO 63028-4100 |
Mailing Address |
Po Box 1449 Maryland Heights MO 63043-0449 |
Practice Telephone | 6369317770 |
Practice Fax Number | 6369317671 |
Mailing Telephone | 3144322580 |
Mailing Fax Number | 3144320223 |
Enumeration Date | 2015-03-03 |
Last Update Date | 2015-04-23 |
Authorized Official Name | ROUBA GHOUSSOUB (OWNER) |
Authorized Official Telephone | 6369317770 |
Authorized Official Credential | M.D. |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207RN0300X |
Internal Medicine Specialization: Nephrology |
Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MO | 1417349234 | 05 |
Street Address |
1400 US HIGHWAY 61 G30 |
City | FESTUS |
State | MO |
Zip Code | 63028-4100 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1588264493 | Kaile Jean Eggemeyer | Nurse Practitioner | 1400 Us Highway 61, Festus, MO 63028-4100 | 2020-10-29 |
1073010419 | Amanda Rae Mcvey | Registered Nurse | 1400 Us Highway 61, Festus, MO 63028-4100 | 2018-04-11 |
1417482530 | Lauren Kerley | Nurse Anesthetist, Certified Registered | 1400 Us Highway 61, Festus, MO 63028-4100 | 2017-04-26 |
1669907242 | Mahmoud Mohamed Elfadil | Internal Medicine | 1400 Us Highway 61, Festus, MO 63028-4100 | 2017-04-20 |
1346797305 | John Westley Pipkin | Nurse Practitioner | 1400 Us Highway 61, Festus, MO 63028 | 2016-09-07 |
1427401579 | Gwendolyn Bailey | Social Worker | 1400 Us Highway 61, Festus, MO 63028-4100 | 2016-07-13 |
1710337274 | Matthew James Crisp | Internal Medicine | 1400 Us Highway 61, Festus, MO 63028-4100 | 2016-06-15 |
1417311242 | Anthony Sanders | Registered Nurse | 1400 Us Highway 61, Festus, MO 63028-4100 | 2016-04-07 |
1780079053 | Debbie Trudell | Counselor | 1400 Us Highway 61, Festus, MO 63028-4100 | 2015-04-02 |
1750788972 | Mercy Clinic Adult Psychiatry, LLC | Psychiatry & Neurology | 1400 Us Highway 61, Suite H1341, Festus, MO 63028-4100 | 2014-12-03 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1952943268 | Lauryn E Morris | Occupational Therapist | 3657 Baptist Park Rd, Mapaville, MO 63028 | 2019-10-09 |
1912557547 | Rena Robinson | Technician | 150 Brandon Wallace Way Suite 1014, Suite 1014, Festus, MO 63028 | 2019-09-16 |
1780232264 | Cynthia L James | Technician | 110 Juliet Place, Festus, MO 63028 | 2019-08-28 |
1700377009 | Akr Endodontics, LLC | Dentist | 1431 Us Hwy 61, Festus, MO 63028 | 2018-05-22 |
1962869990 | Fatma Esen Antakli | Nurse Practitioner | Advanced Pain Centers 190 Industrial Drive, Festus, MO 63028 | 2016-01-21 |
1083088744 | Megan Schomer | Counselor | 2675 Meyer Rd, Festus, MO 63028 | 2015-11-18 |
1043608144 | Elka Follmer | Physical Therapist | 1349 Us Hwy 61, Festus, MO 63028 | 2014-12-26 |
1811394729 | Ashley Schwendeman | Physical Therapist | 1403 N. Truman Blvd, Fesuts, MO 63028 | 2014-11-21 |
1073871257 | Staurla Chantel Waun | Counselor | 10719 Buckeye Rd, Festus, MO 63028 | 2012-04-25 |
1639444086 | Jeffrey Steitz | Otolaryngology | 1390 Us Highway 61 Ste 3100, Festus, MO 63028 | 2012-03-19 |
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Taxonomy Code | 207RN0300X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Internal Medicine |
Specialization | Nephrology |
An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. |
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 |
---|---|---|---|---|
1316186836 | Sarah K Sundet | Internal Medicine | 1400 Us Highway 61 Ste 240, Festus, MO 63028-4141 | 2009-02-05 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1811549389 | Sana Hasan | Internal Medicine | Ce 422, One Hospital Drive University of Missouri, Columbia, MO 65212-0001 | 2019-07-15 |
1295291409 | Zeeshan Azeem | Internal Medicine | 1 Hospital Drive University Hospital, Columbia, MO 65212-0001 | 2019-02-12 |
1932614153 | Mohammad Walid Abuzeineh | Internal Medicine | 1 Hospital Drive Department of Nephrology, Columbia, MO 65211-0001 | 2017-12-11 |
1548788896 | Nephrology Care of St Louis | Internal Medicine | 224 S Woods Mill Rd Ste 460, Chesterfield, MO 63017-3513 | 2017-09-07 |
1033649819 | Taewoo Lee | Internal Medicine | 3635 Vista Ave Saint Louis University Medical Center, Division of Nephrology, Saint Louis, MO 63110 | 2017-06-14 |
1528502978 | Bill Lauderdale | Internal Medicine | 288 State Hwy Y, Forsyth, MO 65653-0010 | 2016-12-05 |
1780058727 | St Louis Kidney Care LLC | Internal Medicine | 11155 Dunn Rd Ste 211n, Saint Louis, MO 63136-6166 | 2015-11-13 |
1104239888 | Sadaf Sheikh | Internal Medicine | 222 S Woods Mill Rd Ste 750n, Chesterfield, MO 63017-3653 | 2014-06-10 |
1225441538 | Tomonori Alan Oyadomari | Internal Medicine | 1009 W Saint Maartens Dr Ste F, Saint Joseph, MO 64506-2990 | 2014-06-04 |
1184056830 | Ralph Robert Hatlelid | Internal Medicine | 318 E Swon Ave, Saint Louis, MO 63119-3112 | 2013-08-05 |
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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.