DR. BRADLEY THOMAS SMITH (NPI# 1588608970) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588608970 |
| Entity Type | Individual |
| Full Name | DR. BRADLEY THOMAS SMITH |
| Credential | MD |
| Practice Address |
17 The Boulevard Saint Louis Saint Louis MO 63117-1118 |
| Mailing Address |
2201 S Brentwood Blvd Saint Louis MO 63144-1870 |
| Practice Telephone | 3143671181 |
| Practice Fax Number | 3149685117 |
| Mailing Telephone | 3143671181 |
| Mailing Fax Number | 3149685117 |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2020-02-04 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207WX0107X |
Ophthalmology Specialization: Retina Specialist |
2006005754 | MO | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851952790 | Bradley Colin Smith | Dentist | 1900 14th St Ste C, Plano, TX 75074-6426 | 2019-06-21 |
| 1164904017 | Bradley Levi Smith | Counselor | 303 Hermitage Rd, Pineville, LA 71360-2623 | 2018-09-06 |
| 1013495308 | Bradley Gene Smith | Speech-Language Pathologist | 3410 Worth St Ste 760, Dallas, TX 75246-2005 | 2018-07-30 |
| 1821449000 | Bradley Smith | Counselor | 8420 Fordham Rd, Apt 2, Los Angeles, CA 90045-2581 | 2016-06-28 |
| 1669837662 | Bradley R Smith | Specialist/Technologist | Berea College Cpo 2187, Berea, KY 40404-0001 | 2015-12-18 |
| 1497034995 | Bradley Michael Smith | Rehabilitation Counselor | 6209 Trail Lake Dr, Fort Worth, TX 76133-3405 | 2011-08-15 |
| 1164725610 | Bradley Dean Smith | Orthotist | 813 Carman Ave Unit A, Westbury, NY 11590-6447 | 2010-12-06 |
| 1306162151 | Bradley Howard Smith | Preventive Medicine | 340 Hulsa Rd, Naval Aerospace Medical Institute, Pensacola, FL 32508-1092 | 2010-04-19 |
| 1639387863 | Bradley M. Smith | Dentist | 401 Harding Way W, Galion, OH 44833-1611 | 2007-05-20 |
| 1902928047 | Bradley J Smith | Family Medicine | 400 Enterprise Dr Fl 2, Limerick, PA 19468-1224 | 2007-04-06 |
| Street Address |
17 THE BOULEVARD SAINT LOUIS |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63117-1118 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669476560 | Kevin J Blinder | Ophthalmology | 17 The Boulevard Saint Louis, Saint Louis, MO 63117-1118 | 2005-06-08 |
| 1780052233 | Gautam Vangipuram | Ophthalmology | 17 The Boulevard Saint Louis, Saint Louis, MO 63117-1118 | 2015-09-14 |
| 1033505086 | Alexander R Bottini | Ophthalmology | 17 The Boulevard Saint Louis, Saint Louis, MO 63117-1118 | 2015-04-07 |
| 1629496849 | Waseem Ansari | Ophthalmology | 17 The Boulevard Saint Louis, Saint Louis, MO 63117-1118 | 2014-04-03 |
| 1205179496 | Himanshu Kumar Banda | Student in an Organized Health Care Education/Training Program | 17 The Boulevard Saint Louis, Saint Louis, MO 63117-1118 | 2013-04-05 |
| 1841558822 | Alia Durrani | Ophthalmology | 17 The Boulevard Saint Louis, Saint Louis, MO 63117 | 2012-04-27 |
| 1700175395 | Retina Consultants, Ltd | Ophthalmology | 17 The Boulevard Saint Louis, Saint Louis, MO 63117-1118 | 2011-04-04 |
| 1740579531 | Sabin Dang | Ophthalmology | 17 The Boulevard Saint Louis, Saint Louis, MO 63117-1118 | 2011-03-31 |
| 1205837978 | Thomas K Krummenacher | Ophthalmology | 17 The Boulevard Saint Louis, Saint Louis, MO 63117-1118 | 2005-08-03 |
| 1508867318 | Richard Joseph Rothman | Ophthalmology | 17 The Boulevard Saint Louis, Saint Louis, MO 63117-1118 | 2005-08-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255956611 | Efehi Kelly Ogbomo | Student in an Organized Health Care Education/Training Program | 6420 Clayton Rd, Suite 2218, St. Louis, MO 63117 | 2020-06-11 |
| 1619533890 | Abdul Rauf | Student in an Organized Health Care Education/Training Program | 6420 Clayton Road. Ssm Health St. Mary's Hospital, St. Louis, MO 63117 | 2019-05-14 |
| 1083278477 | Mohamed Maali Gumaa Mohamed | Student in an Organized Health Care Education/Training Program | 6420 Clayton Road Ssm St. Mary's Hospital, Department of Internal Medicine, St. Louis, MO 63117 | 2019-05-01 |
| 1750945556 | Samrat Jun Jayanth | Student in an Organized Health Care Education/Training Program | 6420 Clayton Road, Ssm Health St Mary's Hospital, St. Louis, MO 63117 | 2019-04-26 |
| 1215491329 | Latonya Allen | Counselor | 1612 S. Big Bend Blvd, St. Louis, MO 63117 | 2019-01-23 |
| 1265917025 | Blue Stars Therapy, LLC | Occupational Therapist | 1101 Edward Terrace, Apt A, St. Louis, MO 63117 | 2018-09-27 |
| 1770060014 | Ultra Care Home Services LLC | Home Health | 7353 Dale Ave, Saint Louis, MO 63117 | 2018-07-19 |
| 1235623562 | Melissa Valerie Taylor | Counselor | Psychological Services of St Louis, LLC, 7110 Oakland Ave, St Louis, MO 63117 | 2018-06-20 |
| 1124517289 | Jideofor Ebony Obodozie | Student in an Organized Health Care Education/Training Program | 6420 Clayton Road, Ssm St. Mary's Hospital, St. Louis, MO 63117 | 2018-05-04 |
| 1770071706 | Sivaram Prabhuji Muppaneni | Student in an Organized Health Care Education/Training Program | Ssm St Mary's Hospital, 6420 Clayton Road, St. Louis, MO 63117 | 2018-04-25 |
| Find all providers in zip 63117 | ||||
| Taxonomy Code | 207WX0107X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| Specialization | Retina Specialist |
| An ophthalmologist who specializes in the diagnosis and treatment of vitreoretinal diseases. |
| Notes: Source: American Society of Retina Specialists, www.asrs.org [1/1/2017: new] - Additional Resources: American Academy of Ophthalmology, www.aao.org. Macula Society, www.maculasociety.org. Retina Society, www.retinasociety.org. Association of University Professors of Ophthalmology, www.aupo.org. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669476560 | Kevin J Blinder | Ophthalmology | 17 The Boulevard Saint Louis, Saint Louis, MO 63117-1118 | 2005-06-08 |
| 1427439298 | Bliss Elizabeth O'bryhim | Ophthalmology | 517 S Euclid Ave, Saint Louis, MO 63110-1007 | 2015-06-17 |
| 1700175395 | Retina Consultants, Ltd | Ophthalmology | 17 The Boulevard Saint Louis, Saint Louis, MO 63117-1118 | 2011-04-04 |
| 1205837978 | Thomas K Krummenacher | Ophthalmology | 17 The Boulevard Saint Louis, Saint Louis, MO 63117-1118 | 2005-08-03 |
| 1508867318 | Richard Joseph Rothman | Ophthalmology | 17 The Boulevard Saint Louis, Saint Louis, MO 63117-1118 | 2005-08-02 |
| 1598764052 | Matthew A Thomas | Ophthalmology | 17 The Boulevard Saint Louis, Saint Louis, MO 63117-1118 | 2005-07-18 |
| 1972502383 | Gaurav Shah | Ophthalmology | 17 The Boulevard Saint Louis, Saint Louis, MO 63117-1118 | 2005-07-18 |
| 1588663009 | Daniel Joseph | Ophthalmology | 17 The Boulevard Saint Louis, Saint Louis, MO 63117-1118 | 2005-07-18 |
| 1841298551 | Mark Gilbert Grand | Ophthalmology | 17 The Boulevard Saint Louis, Saint Louis, MO 63117-1118 | 2005-07-07 |
| 1891791844 | Nicholas Engelbrecht | Ophthalmology | 17 The Boulevard Saint Louis, Saint Louis, MO 63117-1118 | 2005-06-23 |
| Find all providers in SAINT LOUIS | ||||
| City | SAINT LOUIS |
| Zip Code | 63117 |
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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.