DR. STACY KOLLANUR MATHEWS (NPI# 1467089177) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467089177 |
| Entity Type | Individual |
| Full Name | DR. STACY KOLLANUR MATHEWS |
| Credential | MD |
| Practice Address |
1465 S Grand Blvd Saint Louis MO 63104-1003 |
| Practice Telephone | 3142684070 |
| Practice Fax Number | 3142684019 |
| Mailing Telephone | 3142684070 |
| Mailing Fax Number | 3142684019 |
| Enumeration Date | 2020-03-24 |
| Last Update Date | 2020-03-24 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013234939 | Stacy Lolita Mathews | Nurse Practitioner | 11100 Euclid Ave, Cleveland, OH 44106-1716 | 2010-05-03 |
| Street Address |
1465 S GRAND BLVD |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63104-1003 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528676921 | Gunjanpreet Kaur | Student in an Organized Health Care Education/Training Program | 1465 S Grand Blvd, Saint Louis, MO 63104-1003 | 2020-07-21 |
| 1972128510 | Millicent Rose Palacios | Nurse Practitioner | 1465 S Grand Blvd, Saint Louis, MO 63104-1003 | 2020-06-09 |
| 1083241863 | Nathaniel Joseph Conner | Student in an Organized Health Care Education/Training Program | 1465 S Grand Blvd, Saint Louis, MO 63104-1003 | 2020-03-24 |
| 1568099299 | Susan Aye Mya Oo | Student in an Organized Health Care Education/Training Program | 1465 S Grand Blvd, Saint Louis, MO 63104-1003 | 2020-03-24 |
| 1861029514 | Gregory Joseph Weissler II | Student in an Organized Health Care Education/Training Program | 1465 S Grand Blvd, Saint Louis, MO 63104-1003 | 2020-03-24 |
| 1154958874 | Brendan Michael Mcenery | Student in an Organized Health Care Education/Training Program | 1465 S Grand Blvd, Saint Louis, MO 63104-1003 | 2020-03-24 |
| 1316574049 | Satvika Mikkilineni | Student in an Organized Health Care Education/Training Program | 1465 S Grand Blvd, Saint Louis, MO 63104-1003 | 2020-03-24 |
| 1972130607 | Katherine Letha Randolph | Student in an Organized Health Care Education/Training Program | 1465 S Grand Blvd, Saint Louis, MO 63104-1003 | 2020-03-24 |
| 1346877081 | Samuel Ryan Richey | Student in an Organized Health Care Education/Training Program | 1465 S Grand Blvd, Saint Louis, MO 63104-1003 | 2020-03-24 |
| 1396372108 | Margaret Ruth Kirkpatrick | Student in an Organized Health Care Education/Training Program | 1465 S Grand Blvd, Saint Louis, MO 63104-1003 | 2020-03-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407469570 | Family Care Health Centers | Clinic/Center | 2717 Sidney Street, St. Louis, MO 63104 | 2020-08-28 |
| 1023638038 | Laura Ann Humphrey | Physician Assistant | Allied Health Building 3437 Caroline Street, Room 3015, Saint Louis, MO 63104 | 2020-04-20 |
| 1174187264 | Ahsan Ali | Student in an Organized Health Care Education/Training Program | 1438 South Grand Blvd, Monteleone Hall, St. Louis, MO 63104 | 2019-04-24 |
| 1205359916 | Brenda Eve Ladin | Behavior Technician | 1221 Allen Market Lane Rear, St. Louis, MO 63104 | 2017-07-25 |
| 1841722063 | Gustavo G Mendez | Student in an Organized Health Care Education/Training Program | 1465 South Grand Bulevard Rm 2717, Ssm Health Cardinal Glennon Children's Hospital, Saint Louis, MO 63104 | 2017-03-28 |
| 1053776716 | Carmella Harper | Respiratory Therapist, Certified | 2678 Park Ave, St Louis, MO 63104 | 2015-12-23 |
| 1922485986 | Alexander Tremont | Internal Medicine | 1402 S Grand Blvd Rm M260, Saint Louis, MO 63104 | 2015-04-29 |
| 1306233341 | Healthcare R Us | Home Health | 2859 Sidney St, St Louis, MO 63104 | 2015-04-16 |
| 1396159091 | Daniela Hermelin | Pathology | 1402 South Grane, St. Louis, MO 63104 | 2014-06-20 |
| 1992117881 | Kelly Denise Durbin | Social Worker | 1920 S 7th St, Saint Louis, MO 63104 | 2014-05-27 |
| Find all providers in zip 63104 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245845908 | Ali Hamzehloo | Student in an Organized Health Care Education/Training Program | 1155 Appleseed Ln Unit D, Saint Louis, MO 63132-3239 | 2020-09-10 |
| 1114539137 | Brooke Marissa Tubbs | Student in an Organized Health Care Education/Training Program | 5135 Redstone Rd, Saint Louis, MI 48880-9602 | 2020-08-20 |
| 1508475245 | Irfan Yasin | Student in an Organized Health Care Education/Training Program | 1402 S Grand Blvd Dept Of, Saint Louis, MO 63104-1004 | 2020-07-29 |
| 1457978231 | Katherine Coates | Student in an Organized Health Care Education/Training Program | 4534 Olive St Apt 306, Saint Louis, MO 63108-1869 | 2020-06-29 |
| 1184248437 | Catherine Gaines | Student in an Organized Health Care Education/Training Program | 362 S Maple Ave, Saint Louis, MO 63119-3824 | 2020-06-02 |
| 1922620947 | Nicole Werner | Student in an Organized Health Care Education/Training Program | 9669 Amona Ct, Saint Louis, MO 63123-6535 | 2020-05-13 |
| 1043831787 | Reed Welch | Student in an Organized Health Care Education/Training Program | 1501 Fairmount Ave, Saint Louis, MO 63139-3628 | 2020-05-05 |
| 1437779097 | Victoria Emanuelson | Student in an Organized Health Care Education/Training Program | 4048 Cleveland Ave Apt 3w, Saint Louis, MO 63110-3958 | 2020-04-23 |
| 1831727502 | Kiran Ashok Patel | Student in an Organized Health Care Education/Training Program | 4050 W Pine Blvd Apt 3311b, Saint Louis, MO 63108-3294 | 2020-03-30 |
| 1699301507 | Morgann Madill | Student in an Organized Health Care Education/Training Program | 4144 De Tonty St Apt 1d, Saint Louis, MO 63110-2511 | 2020-03-23 |
| Find all providers in SAINT LOUIS | ||||
| City | SAINT LOUIS |
| Zip Code | 63104 |
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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.