ILIA ROSA SUMOZA (NPI# 1548447113) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1548447113 |
Entity Type | Individual |
Full Name | ILIA ROSA SUMOZA |
Credential | MD |
Practice Address |
1011 Bowles Ave Suite G 50 Fenton MO 63026-2395 |
Practice Telephone | 6364964640 |
Practice Fax Number | 6364964962 |
Mailing Telephone | 6364964640 |
Mailing Fax Number | 6364964962 |
Enumeration Date | 2008-01-25 |
Last Update Date | 2012-08-17 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
2011030407 | MO | Allopathic & Osteopathic Physicians |
Street Address |
1011 BOWLES AVE SUITE G 50 |
City | FENTON |
State | MO |
Zip Code | 63026-2395 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1710979208 | Cesar Fernando Munoz | Internal Medicine | 1011 Bowles Ave, Ste. 300, Fenton, MO 63026-2395 | 2005-08-19 |
1083120208 | Tiffany Shanta Harold | Nurse Practitioner | 1011 Bowles Ave, Fenton, MO 63026-2395 | 2017-12-26 |
1093250334 | Laura Ann Rogers | Registered Nurse | 1011 Bowles Ave, Ste 220, Fenton, MO 63026-2395 | 2016-12-22 |
1124579966 | Ssm Medical Group Inc. | Orthopaedic Surgery | 1011 Bowles Ave, Suite 400, Fenton, MO 63026-2395 | 2016-10-17 |
1699158196 | Diane Denise Block | Nurse Practitioner | 1011 Bowles Ave, Suite 300, Fenton, MO 63026-2395 | 2015-07-01 |
1992196992 | Tara Joann Knoepp | Physical Therapist | 1011 Bowles Ave, Suite 150, Fenton, MO 63026-2395 | 2015-02-11 |
1093129538 | Elizabeth Anne Rancour | Dermatology | 1011 Bowles Ave, Ste 121, Fenton, MO 63026 | 2014-06-12 |
1558799742 | Amanda Nicole Meitz | Nurse Practitioner | 1011 Bowles Ave, Suite 205, Fenton, MO 63026-2395 | 2013-10-24 |
1013253699 | Lita Lapins | Nurse Practitioner | 1011 Bowles Ave, Suite 300, Fenton, MO 63026 | 2012-12-30 |
1043568280 | Denise P Blackburn | Registered Nurse | 1011 Bowles Ave, Suite G10, Fenton, MO 63026-2395 | 2012-08-20 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1871000372 | Allison Egler | Audiologist | 1011 Bowles Ave Ste 405, Fenton, MO 63026 | 2018-01-05 |
1629508213 | Holly Brooks Munson | Massage Therapist | 220 Copper Mountain Dr, Fenton, MO 63026 | 2017-06-15 |
1073978862 | Naomi Sharon | Nurse Practitioner | 1101 Bowles Avenue, Suite G50, Fenton, MO 63026 | 2015-12-21 |
1871981704 | Celtic Private Care of Il & Mo, LLC | In Home Supportive Care | 1653 Larkin Williams Road, Suite 201, Fenton, MO 63026 | 2014-12-30 |
1356747513 | Kristina Potts | Nurse Practitioner | 774 Gravois Bluffs Blvd Ste B, Fenton, MO 63026 | 2014-11-14 |
1245642420 | Physicians Health Group Medical Inc | General Practice | 960 S. Highway Dr, Fenton, MO 63026 | 2014-05-22 |
1598047409 | Kevin Eugene Bruce | Pharmacist | 1210 Sugar Creek, Fenton, MO 63026 | 2011-09-16 |
1215186382 | Concentra Health Services, Inc. | Clinic/Center | 128 Matrix Commons Dr., Fenton, MO 63026 | 2008-09-15 |
1790954410 | Castlewood Treatment Center LLC | Community/Behavioral Health | 1855 Bowles Ave, Suite 210, Fenton, MO 63026 | 2008-02-27 |
1073703617 | Christina R Baeres | Dietitian, Registered | 38 Majestic Ct, Fenton, MO 63026 | 2007-07-30 |
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Taxonomy Code | 207RH0003X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Internal Medicine |
Specialization | Hematology & Oncology |
An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |
Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1063618379 | Stephanie Jean Becker-koepke | Internal Medicine | 1011 Bowles Ave Ste G50, Fenton, MO 63026-0562 | 2007-06-23 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1922485986 | Alexander Tremont | Internal Medicine | 1402 S Grand Blvd Rm M260, Saint Louis, MO 63104 | 2015-04-29 |
1538564620 | Bader Alahmari | Internal Medicine | 660 South Euclid Avenue Campus Box 8007, St Louis, MO 63110 | 2014-10-31 |
1235480708 | James Michael Epstein | Internal Medicine | 12008 Heatherdane Dr, Saint Louis, MO 63131-3119 | 2012-09-25 |
1285920694 | Zhineng Jayson Yang | Internal Medicine | 2529 Glenn Hendren Dr Ste G30, Liberty, MO 64068-9610 | 2011-06-23 |
1477782092 | Tamara V Hopkins, Md, LLC | Internal Medicine | 2009 Saint Marys Blvd Ste A, Jefferson City, MO 65109-1509 | 2009-07-02 |
1457591463 | David Douglas Westhoff | Internal Medicine | 3605 Missouri Blvd, Jefferson City, MO 65109-7111 | 2009-03-03 |
1629224357 | Vinay Gupta | Internal Medicine | 110 Ne Saint Lukes Blvd Ste 500, Lees Summit, MO 64086-6075 | 2008-08-13 |
1942456058 | Anuj Shrestha | Internal Medicine | 2310 Holmes St Ste 500, Kansas City, MO 64108-2602 | 2008-08-09 |
1154580777 | Skaggs Community Hospital Association | Internal Medicine | 525 Branson Landing Blvd Ste 101, Branson, MO 65616-2052 | 2008-06-09 |
1326235797 | Getinet Degu Ayalew | Internal Medicine | 12277 De Paul Dr Ste 100, Bridgeton, MO 63044-2577 | 2007-10-01 |
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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.