CARDIAC CIN OF ST LOUIS LLC (NPI# 1437658440) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437658440 |
| Entity Type | Organization |
| Organization Name | CARDIAC CIN OF ST LOUIS LLC |
| Practice Address |
11628 Old Ballas Rd # 346 Saint Louis MO 63141-7030 |
| Mailing Address |
102 Woodmont Blvd Ste 350 Nashville TN 37205-2216 |
| Practice Telephone | 6153860064 |
| Practice Fax Number | 6153860067 |
| Mailing Telephone | 6153860064 |
| Mailing Fax Number | 6153860067 |
| Enumeration Date | 2018-02-05 |
| Last Update Date | 2020-02-14 |
| Authorized Official Name | EDWARD LELAND HUTTON EADIE (DIRECTOR) |
| Authorized Official Telephone | 6157332064 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RI0011X |
Internal Medicine Specialization: Interventional Cardiology |
MO | Allopathic & Osteopathic Physicians | |
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
MO | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 616 S New Ballas Rd, St Louis, MO 631418221 | 6153860064 | 6153860067 |
| Street Address |
11628 OLD BALLAS RD # 346 |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63141-7030 |
| 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 | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://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 |
|---|---|---|---|---|
| 1427315423 | Paul Larsen | Internal Medicine | 1027 Bellevue Ave Ste 200, Saint Louis, MO 63117-1851 | 2012-04-13 |
| 1275899718 | Bradley Carl Witbrodt | Internal Medicine | 3023 N Ballas Rd Ste 200, Saint Louis, MO 63131-2330 | 2012-04-10 |
| 1194004952 | Jad Raffoul | Internal Medicine | 1402 S Grand Blvd Fl 14, Saint Louis, MO 63104-1004 | 2011-08-11 |
| 1982999462 | Philip L Mar | Internal Medicine | 3635 Vista Ave Fl 15, Saint Louis, MO 63110-2539 | 2011-06-13 |
| 1255644191 | Rugheed Ghadban | Internal Medicine | 1402 S Grand Blvd Ste 260, Saint Louis, MO 63104-1004 | 2010-07-20 |
| 1962727404 | Tyson E Turner | Internal Medicine | 625 S New Ballas Rd Ste 2015, Saint Louis, MO 63141 | 2010-03-27 |
| 1649468786 | Midwest Cardiovascular, Inc. | Internal Medicine | 1031 Bellevue Ave Ste 200, Saint Louis, MO 63117-1856 | 2007-10-12 |
| 1124225347 | Pradeep Aaron Chandra | Internal Medicine | 11155 Dunn Rd Ste 304e, Saint Louis, MO 63136-6111 | 2007-06-29 |
| 1699856443 | Miguel Angel Paniagua | Internal Medicine | 12414 Lusher Rd, Saint Louis, MO 63138-1456 | 2006-10-18 |
| 1235147109 | Jerome D Cohen | Internal Medicine | 8138 Westmoreland Ave, Provider Enrollment, Saint Louis, MO 63105-3731 | 2006-08-04 |
| 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.