CARISSA SHANTELL CARSON (NPI# 1578075313) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578075313 |
| Entity Type | Individual |
| Full Name | CARISSA SHANTELL CARSON |
| Practice Address |
615 S New Ballas Rd Saint Louis MO 63141-8221 |
| Mailing Address |
3632 Watson Rd Apt A Saint Louis MO 63109-1232 |
| Practice Telephone | 3142516000 |
| Mailing Telephone | 3143742290 |
| Enumeration Date | 2017-11-02 |
| Last Update Date | 2018-03-17 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 175M00000X | Midwife, Lay | Other Service Providers | ||
| Y | 261QB0400X |
Clinic/Center Specialization: Birthing |
Ambulatory Health Care Facilities | ||
| N | 261QF0050X |
Clinic/Center Specialization: Family Planning, Non-Surgical |
Ambulatory Health Care Facilities | ||
| N | 174N00000X | Lactation Consultant, Non-RN | Other Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 3015 N Ballas Rd, Saint Louis, MO 631312329 | 3148377470 | |
| 3632 Watson Rd Apt A, Saint Louis, MO 631091232 | 3143742290 | |
| 6420 Clayton Rd, Richmond Heights, MO 631171811 | 3147688000 |
| Street Address |
615 S NEW BALLAS RD |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63141-8221 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780689182 | Robert W Allen | Anesthesiology | 615 S New Ballas Rd, Saint Louis, MO 63141-8221 | 2005-06-14 |
| 1033722061 | Ashley Maull | Nurse Practitioner | 615 S New Ballas Rd, Saint Louis, MO 63141-8221 | 2020-08-28 |
| 1508476367 | Ryan Nathan | Student in an Organized Health Care Education/Training Program | 615 S New Ballas Rd, Saint Louis, MO 63141-8221 | 2020-08-06 |
| 1992315857 | Corey Weicht | Nurse Practitioner | 615 S New Ballas Rd, Saint Louis, MO 63141-8221 | 2020-08-05 |
| 1063021905 | Alexandria Colleen Grodie | Nurse Practitioner | 615 S New Ballas Rd, Saint Louis, MO 63141-8221 | 2020-07-27 |
| 1396353892 | Fahad Bin Tahir | Internal Medicine | 615 S New Ballas Rd, Saint Louis, MO 63141-8221 | 2020-07-21 |
| 1588281307 | Alexander Cai | Dentist | 615 S New Ballas Rd, Saint Louis, MO 63141-8221 | 2020-06-26 |
| 1083231070 | Lauren Gonzalez | Anesthesiologist Assistant | 615 S New Ballas Rd, Saint Louis, MO 63141-8221 | 2020-06-25 |
| 1780200253 | Matthew Davis | Internal Medicine | 615 S New Ballas Rd, Saint Louis, MO 63141-8221 | 2020-06-22 |
| 1902422421 | Megan Reidy Landis | Family Medicine | 615 S New Ballas Rd, Saint Louis, MO 63141-8221 | 2020-06-20 |
| Find all providers in the same location | ||||
| 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 | 261QB0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Birthing |
| A freestanding birth center is a health facility other than a hospital where childbirth is planned to occur away from the pregnant woman’s residence, and that provides prenatal, labor and delivery, and postpartum care, as well as other ambulatory services for women and newborns. |
| Notes: Source: Summarized from Social Security Act [42 U.S.C. §1396d(1)(3)(B)] [1/1/2013: added definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447764899 | Missouri Midwifery Service | Clinic/Center | 3840 South Avenue, Springfield, MO 65807 | 2017-11-21 |
| 1104364108 | Sabrina Bias | Clinic/Center | 12330 N Robinson Rd, Hallsville, MO 65255-9398 | 2017-02-09 |
| 1386017648 | Birthcentered | Clinic/Center | 3840 South Ave, Springfield, MO 65807-5285 | 2015-11-09 |
| 1225383649 | Better Birth Services, LLC | Clinic/Center | 2039 S Brentwood Blvd, Springfield, MO 65804-2536 | 2012-07-23 |
| 1265040562 | First Breath Birth and Wellness, LLC | Clinic/Center | 769 W Terra Ln, O Fallon, MO 63366-2432 | 2020-07-22 |
| 1477036853 | Private Healthcare Facilities | Clinic/Center | 9710 E 40 Hwy, Independence, MO 64055-6116 | 2018-09-11 |
| 1376095760 | Carla Sue Rouw | Clinic/Center | 1901 S Ventura Ave, Building B, Springfield, MO 65804-2713 | 2016-11-01 |
| 1104376995 | Edge Medical Services | Clinic/Center | 9710 E 40 Hwy, Independence, MO 64055-6116 | 2016-10-05 |
| 1154796118 | National Birth Centers, Inc | Clinic/Center | 105 W 34th St, Kansas City, MO 64111-1315 | 2015-12-02 |
| 1558735225 | National Birth Centers Inc | Clinic/Center | 9710 E 40 Hwy, Independence, MO 64055-6116 | 2015-11-18 |
| Find all providers with the same taxonomy | ||||
| City | SAINT LOUIS |
| 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.