DR. TIMOTHY TOBIN BRADY (NPI# 1518056258) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518056258 |
| Entity Type | Individual |
| Full Name | DR. TIMOTHY TOBIN BRADY |
| Credential | MD |
| Practice Address |
10012 Kennerly Rd Ste 101 St Louis MO 63128 |
| Mailing Address |
Po Box 23340 Saint Louis MO 63156-3340 |
| Practice Telephone | 3145435200 |
| Practice Fax Number | 3145435219 |
| Mailing Telephone | 3145435200 |
| Mailing Fax Number | 3145435219 |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2013-08-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
R9C27 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 202249520 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225050529 | Timothy P. Brady | Dentist | 140 Punzalan St, C/o Guam Dental Arts, Tamuning, GU 96913-3441 | 2006-07-24 |
| 1942253208 | Timothy B Brady | Internal Medicine | 9443 E. 38th St., Indianapolis, IN 46236-2132 | 2006-05-18 |
| 1568994903 | Timothy Brady | Pediatrics | 2821 Maplewood Ave, Winston Salem, NC 27103-4137 | 2017-04-03 |
| 1801024666 | Timothy J Brady | Nurse Anesthetist, Certified Registered | 601 N 30th St, Suite 3222, Omaha, NE 68131-2137 | 2009-06-30 |
| 1114059813 | Timothy Daniel Brady | Psychologist | 2580 E Main St, Suite 100, Ventura, CA 93003-2646 | 2007-03-09 |
| 1417099045 | Timothy Francis Brady | Dentist | 111 Mason St, Newark, NY 14513-1459 | 2007-02-12 |
| 1346386554 | Timothy H Brady | Social Worker | 192 Chestnut Ridge Rd, West Union, OH 45693-9584 | 2007-01-29 |
| 1083680383 | Timothy J. Brady | Dentist | 1647 Admiral Taussig Blvd, Norfolk, VA 23511-2803 | 2006-02-27 |
| 1720074792 | Timothy K. Brady | Chiropractor | 514 28 1/4 Rd, Suite 1, Grand Junction, CO 81501-4961 | 2005-09-23 |
| Street Address |
10012 KENNERLY RD STE 101 |
| City | ST LOUIS |
| State | MO |
| Zip Code | 63128 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780889071 | Iman Abou Assi | Registered Nurse | 10012 Kennerly Rd, #301 Gateway Cardiology PC, St Louis, MO 63128 | 2007-06-18 |
| 1619178035 | Cori L Blasa | Registered Nurse | 10012 Kennerly Rd, #301 Gateway Cardiology PC, St Louis, MO 63128 | 2007-05-31 |
| 1871702209 | Picha Moolsintong | Internal Medicine | 10012 Kennerly Rd, Suite 101, St Louis, MO 63128 | 2007-05-22 |
| 1639236136 | St Louis Gastroenterology Consultants PC | Internal Medicine | 10012 Kennerly Rd, St Louis, MO 63128 | 2007-01-03 |
| 1376632018 | James W Dimitroff | Internal Medicine | 10012 Kennerly Rd, Suite 101, St Louis, MO 63128 | 2006-10-12 |
| 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 | 207RG0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Gastroenterology |
| An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. |
| 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 |
|---|---|---|---|---|
| 1992050702 | Christine Boumitri | Internal Medicine | 3635 Vista Avenue, Desloge Towers - 9th Floor South, St Louis, MO 63110 | 2012-07-17 |
| 1871702209 | Picha Moolsintong | Internal Medicine | 10012 Kennerly Rd, Suite 101, St Louis, MO 63128 | 2007-05-22 |
| 1639236136 | St Louis Gastroenterology Consultants PC | Internal Medicine | 10012 Kennerly Rd, St Louis, MO 63128 | 2007-01-03 |
| 1376632018 | James W Dimitroff | Internal Medicine | 10012 Kennerly Rd, Suite 101, St Louis, MO 63128 | 2006-10-12 |
| 1699783563 | Brent A Neuschwander-tetri | Internal Medicine | 3660 Vista, St Louis, MO 63110 | 2006-08-04 |
| 1134137011 | Banke Agarwal | Internal Medicine | 3660 Vista, St Louis, MO 63110 | 2006-08-04 |
| 1043228927 | Charlene M Prather | Internal Medicine | 3660 Vista, St Louis, MO 63110 | 2006-08-04 |
| 1821022682 | Jill E Elwing | Internal Medicine | 621 S New Ballas Rd, 1001b, St Louis, MO 63141 | 2006-07-10 |
| 1114984242 | Midwest Gastroenterology & Hepatology PC | Internal Medicine | 621 S New Ballas Rd, #1001b, St Louis, MO 63141 | 2006-05-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316589708 | Gastroenterology of The Four States,llc | Internal Medicine | 2024 S Maiden Ln Ste 204, Joplin, MO 64804-0319 | 2019-10-17 |
| 1013414317 | Digestive Consultants LLC | Internal Medicine | 222 S Woods Mill Rd Ste 410, Chesterfield, MO 63017 | 2018-04-12 |
| 1184038788 | Prianka Radhika Chilukuri | Internal Medicine | 3635 Vista Avenue, Fdt 9 South, St. Louis, MO 63110 | 2014-06-12 |
| 1871911149 | Sean Doran | Internal Medicine | 2521 Glenn Hendren Dr Ste 408, Liberty, MO 64068-3388 | 2014-04-02 |
| 1215359484 | Advanced Gastroenterology & Colon Cancer Screening Center LLC | Internal Medicine | 763 S New Ballas Rd # 265, Saint Louis, MO 63141-8704 | 2014-01-07 |
| 1689014276 | Antonio Ricardo Cheesman Rocca | Internal Medicine | 1225 S Grand Blvd Fl 3, Saint Louis, MO 63104-1016 | 2013-06-27 |
| 1578805610 | Paul Edmond St. Romain | Internal Medicine | 2115 S Fremont Ave Ste 3300, Springfield, MO 65804-2246 | 2013-03-26 |
| 1114285947 | Samuel Wieland Schowengerdt | Internal Medicine | 5330 N Oak Trfy Ste 102, Kansas City, MO 64118 | 2012-04-30 |
| 1720346729 | Kayci Renee Huff-hardy | Internal Medicine | 621 S New Ballas Rd Ste 437a, Saint Louis, MO 63141-8259 | 2012-04-26 |
| 1649542713 | Robert Earl Stufflebam | Internal Medicine | 3895 E Pond Apple Dr, Springfield, MO 65809-3752 | 2012-02-03 |
| Find all providers with the same taxonomy | ||||
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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.