DR. DENNIS J KEITHLY (NPI# 1518069087) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518069087 |
| Entity Type | Individual |
| Full Name | DR. DENNIS J KEITHLY |
| Credential | MD |
| Practice Address |
621 S New Ballas Rd Creve Coeur MO 63141-8232 |
| Practice Telephone | 3142516816 |
| Mailing Telephone | 3142516816 |
| Enumeration Date | 2006-09-03 |
| Last Update Date | 2015-03-31 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | 34589 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 1518069087 | 05 | |
| MO | RAILROAD MEDICARE | P00650207 | 01 |
| Street Address |
621 S NEW BALLAS RD |
| City | CREVE COEUR |
| State | MO |
| Zip Code | 63141-8232 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417578246 | Benjamin Chase Shultes | Anesthesiologist Assistant | 621 S New Ballas Rd, Creve Coeur, MO 63141-8232 | 2020-05-04 |
| 1659799575 | Ophthalmology Consultants, Ltd | Ophthalmology | 621 S New Ballas Rd, Suite 5006b, Creve Coeur, MO 63141-8232 | 2014-03-29 |
| 1306076120 | Mikael Garri | Internal Medicine | 621 S New Ballas Rd, Suite 3016b, Creve Coeur, MO 63141-8232 | 2009-07-15 |
| 1114114691 | Childrens Endocrine Care of St. Louis, LLC | Pediatrics | 621 S New Ballas Rd, Suite 3002 B, Creve Coeur, MO 63141-8232 | 2007-09-28 |
| 1750591053 | David Edward Tannehill | Internal Medicine | 621 S New Ballas Rd, Creve Coeur, MO 63141-8232 | 2007-05-23 |
| 1376667964 | David C. Wallace | Pharmacist | 621 S New Ballas Rd, Creve Coeur, MO 63141-8232 | 2007-03-19 |
| 1962551176 | St Louis County Internal Medicine Inc | Internal Medicine | 621 S New Ballas Rd, Suite 507a, Creve Coeur, MO 63141 | 2007-01-09 |
| 1275696866 | Thao Tran Marquez | Surgery | 621 S New Ballas Rd, Suite 7011b, Creve Coeur, MO 63141-8232 | 2006-12-18 |
| 1740398593 | Lisa S. Etzwiler | Emergency Medicine | 621 S New Ballas Rd, St. John's Mercy Medical Center, Suite 6006, Tower B, Creve Coeur, MO 63141-8232 | 2006-08-29 |
| 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 | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336270297 | Thomas F Wheeler | Emergency Medicine | 615 S New Ballas Rd, Emergency Medicine, Creve Coeur, MO 63141-8221 | 2007-03-09 |
| 1952413171 | Daniel Patrick Emerson | Emergency Medicine | 615 S New Ballas Rd, Emergency Department, Creve Coeur, MO 63141-8221 | 2006-09-01 |
| 1598874448 | Steven Hilton | Emergency Medicine | 625 S New Ballas Rd, St. John's Heart Hospital, B Level, Emergency Offices, Creve Coeur, MO 63141-8253 | 2006-08-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053972349 | Alanna Diamond | Emergency Medicine | One Hospital Drive Emergency Medicine M652 Dc029.10, Columbia, MO 65212-0001 | 2019-06-26 |
| 1013573146 | Michael Habhab | Emergency Medicine | 1 Hospital Dr Emergency Medicine M562 Dc029.10, Columbia, MO 65212-0001 | 2019-05-14 |
| 1043730716 | Ian James Becker | Emergency Medicine | 1 Hospital Dr # Dc029.10, Columbia, MO 65212-1000 | 2017-06-23 |
| 1649628454 | Sphere Medical Group | Emergency Medicine | 916 Olive St Fl 4, Saint Louis, MO 63101-1459 | 2016-06-02 |
| 1487002523 | Christopher Adam Waranch | Emergency Medicine | University of Missouri Columbia, Department of Emergency Medicine, Columbia, MO 65212-0001 | 2016-05-31 |
| 1306220488 | Andrea Marie-gioia Spangler | Emergency Medicine | 1235 E Cherokee St Dept Of, Springfield, MO 65804-2203 | 2015-07-17 |
| 1205219045 | Maria Christina Creel-bulos | Emergency Medicine | 660 South Euclid Avenue Cb 8072, St Louis, MO 63110 | 2015-06-29 |
| 1669853230 | Megan Litzau | Emergency Medicine | 615 S New Ballas Road, St Louis, MO 63141 | 2015-06-09 |
| 1366829426 | Bigeye Emergency Physicians LLC | Emergency Medicine | 10 South Hospital Deive, Fulton, MO 65251 | 2015-04-28 |
| 1972999225 | Timothy O Olatunde | Emergency Medicine | 4410 Wornall Road, Kansas City, MO 64111 | 2015-04-14 |
| Find all providers with the same taxonomy | ||||
| City | CREVE COEUR |
| 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.