MR. GREGORY CHARLES WOMACK SR. (NPI# 1538703020) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538703020 |
| Entity Type | Individual |
| Full Name | MR. GREGORY CHARLES WOMACK SR. |
| Credential | LPN |
| Practice Address |
4929 Wise Ave Saint Louis MO 63110-1418 |
| Practice Telephone | 3148144388 |
| Mailing Telephone | 3148144388 |
| Enumeration Date | 2019-10-29 |
| Last Update Date | 2019-10-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 164W00000X | Licensed Practical Nurse | 2012013815 | MO | Nursing Service Providers |
| Street Address |
4929 WISE AVE |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63110-1418 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659971992 | Carrie Ellen Smith | Nurse Practitioner | Mailstop 90-00-174, One Barnes-jewish Plaza, St. Louis, MO 63110 | 2020-10-27 |
| 1881210466 | Michelle Amanda Freilich | Internal Medicine | Barnes-jewish Plaza, St. Louis, MO 63110 | 2020-06-19 |
| 1245856046 | Jeevin Shahi | Radiology | 3685 Vista Avenue, Center for Radiation Medicine, St. Louis, MO 63110 | 2020-06-18 |
| 1497371314 | Wilson Eduardo Rodriguez | Student in an Organized Health Care Education/Training Program | 1008 S. Spring, St Louis, MO 63110 | 2020-06-17 |
| 1578184065 | Kathryn Kay Lindsay | Registered Nurse | Saint Louis University Dept of Surgery, 3635 Vista Ave 3dt, St Louis, MO 63110 | 2020-05-06 |
| 1881232700 | Ashley Diane Pace | Nurse Practitioner | 1 Parkview Place, Shoenberg 6900, St. Louis, MO 63110 | 2019-12-11 |
| 1619520418 | Krithika Damodar Shenoy | Pathology | 660 Euclid Avenue, One Barnes Jewish Hospital Plaza, St. Louis, MO 63110 | 2019-07-20 |
| 1467912550 | Ian Ferguson | Dermatology | 660 S Euclid Ave., Cb 8123, St. Louis, MO 63110 | 2019-03-23 |
| 1760978688 | Ihab Hassanieh | Student in an Organized Health Care Education/Training Program | 33660 Vista Ave, St. Louis, MO 63110 | 2018-07-03 |
| 1336634500 | Martin K Mwangi | Pediatrics | 1 Childrens Place, 3s34, St. Louis, M, MO 63110 | 2018-06-28 |
| Find all providers in zip 63110 | ||||
| Taxonomy Code | 164W00000X |
| Grouping | Nursing Service Providers |
| Classification | Licensed Practical Nurse |
| An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states. |
| Notes: Source: Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609481969 | Kelei Mitchell | Licensed Practical Nurse | 906 Eichelberger St, Saint Louis, MO 63111-1603 | 2020-09-14 |
| 1649897547 | Cheryl Vetter | Licensed Practical Nurse | 1034 S Brentwood Blvd Ste 1540, Saint Louis, MO 63117-1229 | 2020-06-26 |
| 1376012138 | Krystal K Bradford | Licensed Practical Nurse | 157 Signal Hill Dr, Saint Louis, MO 63121-1219 | 2018-11-21 |
| 1528549946 | Desola R Nunley | Licensed Practical Nurse | 5057 Gravois Ave, Saint Louis, MO 63116-2342 | 2018-08-23 |
| 1033696653 | Akia Jenae Walton | Licensed Practical Nurse | 1430 Olive St Ste 100, Saint Louis, MO 63103-2303 | 2018-07-26 |
| 1083116792 | Rachael Simpson | Licensed Practical Nurse | 1409 Washington Ave Ste 511, Saint Louis, MO 63103-1901 | 2018-03-08 |
| 1932608205 | Naomia Wright | Licensed Practical Nurse | 7823 Contour Dr, Saint Louis, MO 63121-2165 | 2018-02-01 |
| 1679087753 | Trinity Health Care Services | Licensed Practical Nurse | 1033 Corporate Square Dr Ste 125, Saint Louis, MO 63132-2928 | 2017-11-27 |
| 1457756850 | Trdell Denise Overbey | Licensed Practical Nurse | 11960 Westline Industrial Dr # 2, Saint Louis, MO 63146-3209 | 2014-10-28 |
| 1801291398 | Deangela Edwards | Licensed Practical Nurse | 2638 San Rafael Pl, Saint Louis, MO 63114-5135 | 2014-10-27 |
| Find all providers in SAINT LOUIS | ||||
| City | SAINT LOUIS |
| Zip Code | 63110 |
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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.