JOHN MELLAS (NPI# 1497712079) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497712079 |
| Entity Type | Individual |
| Full Name | JOHN MELLAS |
| Credential | MD |
| Practice Address |
10004 Kennerly Rd Ste 374b St Louis MO 63128 |
| Practice Telephone | 3148429669 |
| Practice Fax Number | 3148421017 |
| Mailing Telephone | 3148429669 |
| Mailing Fax Number | 3148421017 |
| Enumeration Date | 2006-04-27 |
| Last Update Date | 2011-09-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RN0300X |
Internal Medicine Specialization: Nephrology |
R3E73 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 202250106 | 05 |
| Street Address |
10004 KENNERLY RD STE 374B |
| City | ST LOUIS |
| State | MO |
| Zip Code | 63128 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447330295 | Steven Davis West | Dentist | 10004 Kennerly Rd, Suite 240, St Louis, MO 63128 | 2006-10-16 |
| 1033218102 | David Earl Goodman | Dentist | 10004 Kennerly Rd, Suite 240, St Louis, MO 63128 | 2006-09-22 |
| 1962518605 | James Norbert Purtell | Internal Medicine | 10004 Kennerly Rd, St Louis, MO 63128 | 2006-08-23 |
| 1619912797 | St Louis Nephrology Associates LLC | Specialist | 10004 Kennerly Rd, Suite 315 A, St Louis, MO 63128 | 2006-06-20 |
| 1790734994 | Nicholas Gourtzelis | Internal Medicine | 10004 Kennerly Rd, Ste 374b, St Louis, MO 63128 | 2006-05-08 |
| 1982695888 | Steven E. West | Otolaryngology | 10004 Kennerly Rd, Sle 183b, St Louis, MO 63128 | 2005-10-31 |
| 1235120130 | Emily E Ziaee | Otolaryngology | 10004 Kennerly Rd, Sle 183b, St Louis, MO 63128 | 2005-10-31 |
| 1629069521 | Jose A Lima | Otolaryngology | 10004 Kennerly Rd, Ste 183b, St Louis, MO 63128 | 2005-10-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235771155 | James T Fetsch Dmd LLC | Dentist | 10004 Kennerly Rd Suite 240, Saint Louis, MO 63128 | 2019-10-11 |
| 1326504655 | Nikodem Dental Holdings | Dentist | 4337 Butler Hill Rd Suite G, St Louis Mo, MO 63128 | 2019-02-12 |
| 1932678505 | Michelle Anne Arvidson | Physical Therapy Assistant | Elite Physical Therapy, 12608 Lamplighter Square Shopping Center, St. Louis, MO 63128 | 2018-11-13 |
| 1245726710 | Kristen Rider | Nurse Practitioner | 9964 Kennerly Rd Ste D, Saint Louis, MO 63128 | 2018-07-07 |
| 1306217427 | Sophia Bednarski | Dentist | 12660 Lamplighter Square Shopping Center, St. Louis, MO 63128 | 2015-10-15 |
| 1427434224 | Darcie Burrus | Counselor | 12523 Old Tesson Rd G, St Louis, MO 63128 | 2015-08-04 |
| 1710368584 | Sara Hawatmeh | Internal Medicine | 12345 W Bend Dr Ste 304, Saint Louis, MO 63128 | 2015-06-17 |
| 1871989590 | Celia Grace Montes-kolence | Speech-Language Pathologist | 12335 W Bend Drive, Saint Louis, MO 63128 | 2015-04-09 |
| 1245629302 | Marius Antonio Evans | Dentist | 9911 Kennerly Rd., Suite G, St. Louis, MO 63128 | 2015-01-13 |
| 1801230313 | Sarah Elizabeth Walsh | Emergency Medicine | 10010 Kennerly Road, Emergency Department, St. Anthony's Medical Center, St. Louis, MO 63128 | 2013-04-26 |
| Find all providers in zip 63128 | ||||
| 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 |
|---|---|---|---|---|
| 1346330081 | Bruce Jeffrey Lippmann | Internal Medicine | 621 S New Ballas Rd, Suite 3015b, St Louis, MO 63141-8244 | 2006-10-13 |
| 1669571238 | Mark Douglas Ravenscraft | Internal Medicine | 621 S New Ballas Rd, Suite 3015b, St Louis, MO 63141-8244 | 2006-09-21 |
| 1730288317 | Robyn Hayley Jacobs | Internal Medicine | 621 S New Ballas Rd, Suite 3015b, St Louis, MO 63141-8244 | 2006-09-21 |
| 1235140864 | Kevin J Martin | Internal Medicine | 3660 Vista, St Louis, MO 63110 | 2006-08-10 |
| 1790734994 | Nicholas Gourtzelis | Internal Medicine | 10004 Kennerly Rd, Ste 374b, St Louis, MO 63128 | 2006-05-08 |
| 1366409948 | Heidi E Joist | Internal Medicine | 10004 Kennerly Road, Suite 374b, St Louis, MO 63128 | 2006-04-27 |
| 1740251198 | Stanley W Buck | Internal Medicine | 11125 Dunn Rd, Ste 304, St Louis, MO 63136 | 2006-02-01 |
| 1437120888 | Erik D Daniels | Internal Medicine | 11125 Dunn Rd, Ste 304, St Louis, MO 63136 | 2006-02-01 |
| 1740261783 | Rosemary Ouseph | Internal Medicine | 3635 Vista Ave, St Louis, MO 63110 | 2005-11-08 |
| 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 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on JOHN MELLAS.
| 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.