DEREK CHRISTOPHER BRADDIX (NPI# 1588110480) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1588110480 |
Entity Type | Individual |
Full Name | DEREK CHRISTOPHER BRADDIX |
Practice Address |
9717 Landmark Parkway Dr Saint Louis MO 63127-1628 |
Mailing Address |
1119 Mississippi Ave Apt 115 Saint Louis MO 63104-2457 |
Practice Telephone | 7754236400 |
Mailing Telephone | 3143235316 |
Enumeration Date | 2016-08-30 |
Last Update Date | 2020-09-28 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
2016025007 | MO | Physician Assistants & Advanced Practice Nursing Providers |
Street Address |
9717 LANDMARK PARKWAY DR |
City | SAINT LOUIS |
State | MO |
Zip Code | 63127-1628 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1285630061 | Erin Scott Gardner | Dermatology | 9717 Landmark Parkway Dr, Ste 115, Saint Louis, MO 63127-1628 | 2005-06-25 |
1801430442 | Sophai Thach | Nurse Practitioner | 9717 Landmark Parkway Dr, Saint Louis, MO 63127-1628 | 2019-11-06 |
1609242619 | The Health & Wellness Center for Men, LLC | Nurse Practitioner | 9717 Landmark Parkway Dr, Suite 115, Saint Louis, MO 63127-1628 | 2015-08-13 |
1568796514 | Victoria Dean Pannett | Counselor | 9717 Landmark Parkway Dr, Suite 208, Saint Louis, MO 63127-1628 | 2009-09-23 |
1982897450 | Aesthetic Dermatologic Surgery | Dermatology | 9717 Landmark Parkway Dr, Suite 115, Saint Louis, MO 63127-1628 | 2007-08-19 |
1750599841 | Mary Jo Anne Wagner | Physical Therapist | 9717 Landmark Parkway Dr, #216, Saint Louis, MO 63127-1628 | 2007-05-20 |
1740405547 | Thomas E Gaegiula, D.c., P.C. | Chiropractor | 9717 Landmark Parkway Dr, Suite 216, Saint Louis, MO 63127-1628 | 2007-04-16 |
1720101215 | Shawn P. Reiter D.c.p.c. | Chiropractor | 9717 Landmark Parkway Dr, Suite 216, Saint Louis, MO 63127-1628 | 2007-04-09 |
1457487100 | Shawn Reiter | Chiropractor | 9717 Landmark Parkway Dr, 216, Saint Louis, MO 63127-1628 | 2007-02-26 |
1215072640 | Thomas Edward Gargiula | Chiropractor | 9717 Landmark Parkway Dr, Suite 216, Saint Louis, MO 63127-1628 | 2007-02-21 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1730698374 | Advanced Surgical Center of Sunset Hills LLC | Clinic/Center | 4594 S Lindbergh Blvd, Saint Louis, MO 63127 | 2017-09-27 |
1811382179 | Robert Paul Hintze | Dentist | 3555 Sunset Office Dr Ste 210, Saint Louis, MO 63127 | 2015-04-03 |
1639560782 | Bwell Pharmacy LLC | Pharmacy | 12128 Gravois Road, St.louis, MO 63127 | 2015-02-11 |
1043612773 | Braham Dev Dewan | Internal Medicine | 9917 Grandview Forest Court, Saint Louis, MO 63127 | 2014-09-25 |
1639518673 | Jonathan Yoon | Otolaryngology | 9701 Landmark Parkway Dr Ste 201, Saint Louis, MO 63127 | 2013-06-24 |
1639515315 | Kathleen Mary Lowe | Internal Medicine | 3844 S Lindbergh Blvd Ste 120, Saint Louis, MO 63127 | 2013-05-21 |
1366782088 | Sunset Hills Family Chiropractic LLC | Clinic/Center | 4600 South Lindbergh Ave, Suite 3, St. Louis, MO 63127 | 2013-02-15 |
1063743300 | John Ralph Firth | Dentist | 3890 So. Lindbergh Blvd., Suite 115, Sunset Hills, MO 63127 | 2010-01-27 |
1174762850 | Antonio I Longrais | Dentist | 4600 S. Lindbeigh 63127, St. Louis, MO 63127 | 2009-02-19 |
1447439716 | George D Bankhead Dds Ms PC | Dentist | 3890 S Lindbergh Blvd, Suite 115, Sunset Hills, MO 63127 | 2007-11-02 |
Find all providers in zip 63127 |
Taxonomy Code | 363LF0000X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Family |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1134720816 | Blake Christian Cory | Nurse Practitioner | 615 S Ballas Rd # 2015, Saint Louis, MO 63122-5314 | 2020-11-08 |
1265032346 | Sara Lynn Gillespie | Nurse Practitioner | 2424 S 9th St Apt 215, Saint Louis, MO 63104-4717 | 2020-10-28 |
1174123509 | Megan Ashley Wagner | Nurse Practitioner | 10012 Kennerly Rd Ste 406, Saint Louis, MO 63128-2197 | 2020-10-26 |
1467059972 | Anissa Rasul | Nurse Practitioner | 10631 Thayer Dr, Saint Louis, MO 63123-6018 | 2020-10-07 |
1124635388 | Brittney Sherrell Burks | Nurse Practitioner | 10314 Briar Hollow Dr Apt 7, Saint Louis, MO 63146-5777 | 2020-09-30 |
1629684865 | Nicole Burdge | Nurse Practitioner | 9230 Laurel Hill Dr, Saint Louis, MO 63126-2820 | 2020-09-22 |
1932724614 | Oluwatoyin Olufunke Adegboyega | Nurse Practitioner | 3318 Saint Vincent Ave, Saint Louis, MO 63104-1338 | 2020-06-09 |
1497376487 | Jessica A Spring | Nurse Practitioner | 6023 Lansdowne Ave, Saint Louis, MO 63109-2243 | 2020-04-30 |
1932728466 | Lucy Wachuka Kamau | Nurse Practitioner | 4412 Clarence Ave, Saint Louis, MO 63115-3108 | 2020-04-14 |
1275169567 | Lindsay Jones | Nurse Practitioner | 1115 Olivette Executive Pkwy Ste 100, Saint Louis, MO 63132-3265 | 2020-03-18 |
Find all providers in SAINT LOUIS |
City | SAINT LOUIS |
Zip Code | 63127 |
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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.