JENNIFER L ETLING (NPI# 1528020328) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528020328 |
| Entity Type | Individual |
| Full Name | JENNIFER L ETLING |
| Other Name | JENNIFER L DELAMIELLEURE |
| Credential | MD |
| Practice Address |
6 Jungermann Circle Ste 205 St Peters MO 63376 |
| Practice Telephone | 6364412122 |
| Practice Fax Number | 6364415290 |
| Mailing Telephone | 6364412122 |
| Mailing Fax Number | 6364415290 |
| Enumeration Date | 2006-04-05 |
| Last Update Date | 2010-06-04 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | 2005000203 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| UNITED HEALTHCARE | 1700267 | 01 | |
| ESSENCE | 12593 | 01 | |
| BLUE CHOICE | 165817 | 01 | |
| MEDICARE ARKANSAS | M6725 | 01 | |
| RAILROAD MEDICARE | P00195292 | 01 | |
| HEALTHLINK | 487573 | 01 | |
| PRODENTIAL | 4309109800 | 01 | |
| MERCY | H74520 | 01 | |
| BLUE SHIELD | 165817 | 01 | |
| GHP | 231210 | 01 | |
| AETNA | 7986366 | 01 | |
| EXCLUSIVE CHOICE | 017283 | 01 | |
| MO | 209370105 | 05 |
| Street Address |
6 JUNGERMANN CIRCLE STE 205 |
| City | ST PETERS |
| State | MO |
| Zip Code | 63376 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548238751 | Daniel Joseph Bergmann | Surgery | 6 Jungermann Circle, Ste 205, St Peters, MO 63376 | 2006-03-14 |
| 1043476385 | Richard E Parcinski Do Fccp LLC | Internal Medicine | 6 Jungermann Circle, Ste 121, St Peters, MO 63376-1618 | 2008-08-06 |
| 1174585160 | Laurel Ann Yeager | Surgery | 6 Jungermann Circle, Ste 205, St Peters, MO 63376 | 2006-04-05 |
| 1164484994 | Kenneth Allen Hacker | Surgery | 6 Jungermann Circle, Ste 205, St Peters, MO 63376 | 2006-04-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275047946 | Nicholas Christian Schultz | Dentist | 100 Piper Hill Dr Ste A, Saint Peters, MO 63376 | 2017-11-16 |
| 1982120093 | Carol Weber | Speech-Language Pathologist | 166 Boone Hills Dr., St Peters, MO 63376 | 2017-08-21 |
| 1619424744 | Forefront Dermatology, S.c. | Dermatology | 5700 Mexico Rd, Suite 14, Saint Peters, MO 63376 | 2016-09-07 |
| 1508310632 | Preferred Family Healthcare, Inc. | Counselor | 2120 Parkway Dr, Saint Peters, MO 63376 | 2016-08-05 |
| 1598130676 | Delta Center Personal Attendant Services | In Home Supportive Care | 3833 Mcclay, Suite 61, St. Peters, MO 63376 | 2015-12-01 |
| 1427420314 | Barbara Marlene Edelman | Counselor | 1286 Jungerman Rd. Suite G, St. Peters, MO 63376 | 2015-10-30 |
| 1255740247 | Claire Williams | Dentist | 340 Mid Rivers Mall Drive, Suite E, St. Peters, MO 63376 | 2014-08-05 |
| 1184042855 | Keith Wickenhauser | Internal Medicine | 201 Bjc Saint Peters Dr Ste 100, Saint Peters, MO 63376 | 2014-03-31 |
| 1821415233 | Abby Link | Physician Assistant | 107 Piper Parkway, #150, St. Peters, MO 63376 | 2014-03-24 |
| 1225452105 | Ashley Gagel | Physical Therapist | 7055 Mexico Rd Suite 1601, St. Peters, MO 63376 | 2014-02-12 |
| Find all providers in zip 63376 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548238751 | Daniel Joseph Bergmann | Surgery | 6 Jungermann Circle, Ste 205, St Peters, MO 63376 | 2006-03-14 |
| 1174585160 | Laurel Ann Yeager | Surgery | 6 Jungermann Circle, Ste 205, St Peters, MO 63376 | 2006-04-05 |
| 1164484994 | Kenneth Allen Hacker | Surgery | 6 Jungermann Circle, Ste 205, St Peters, MO 63376 | 2006-04-05 |
| 1679575161 | Jerry R Meyers | Surgery | 4201 S Cloverleaf Dr, St Peters, MO 63376-6438 | 2005-08-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134623317 | Kuirong Jiang | Surgery | 1 Hospital Dr Rm Mc520, Columbia, MO 65212-1000 | 2018-03-21 |
| 1962926311 | Blaire Lori Anderson | Surgery | 4921 Parkview Place Ste 8c, St Louis, MO 63110 | 2017-07-27 |
| 1578084349 | Shoaib Safiullah | Surgery | 1 Hospital Dr # Dc075.00, Columbia, MO 65212-1000 | 2017-07-03 |
| 1003336934 | Bradley Kushner | Surgery | 660 S Euclid Ave Fl 9, Saint Louis, MO 63110-1010 | 2017-06-21 |
| 1982088571 | Maxwell Tanyi Fohtung | Surgery | 4949 W Pine Blvd, Saint Louis, MO 63108 | 2015-07-14 |
| 1376920538 | Jordan M Kirsch | Surgery | 660 S. Euclid Ave, Cb 8109, Saint Louis, MO 63110-1020 | 2015-04-27 |
| 1194117861 | Kaitlyn Marie Rountree | Surgery | 1 Hospital Dr # Mc404, Columbia, MO 65212-1000 | 2015-03-04 |
| 1003231002 | Mysorekar Surgical | Surgery | 8342 Delcrest Dr, Apt 303, Saint Louis, MO 63124-2100 | 2014-02-27 |
| 1588099725 | Francis Milton Corry | Surgery | 2859 E. Utica, Springfield, MO 65804 | 2013-09-06 |
| 1710327879 | Jason Matthew Loden | Surgery | 1333 S Sam Houston Blvd Ste C, Houston, MO 65483-2046 | 2013-07-03 |
| 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.