DR. PAUL R GANNINGER (NPI# 1588625693) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588625693 |
| Entity Type | Individual |
| Full Name | DR. PAUL R GANNINGER |
| Credential | M.D. |
| Practice Address |
1585 Woodlake Dr Suite 100 Chesterfield MO 63017-5740 |
| Mailing Address |
Po Box 23340 Saint Louis MO 63156-3340 |
| Practice Telephone | 3144344278 |
| Practice Fax Number | 3148514466 |
| Mailing Telephone | 3144344278 |
| Mailing Fax Number | 3148514466 |
| Enumeration Date | 2006-03-29 |
| Last Update Date | 2015-02-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 2003003397 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 209094002 | 05 |
| Street Address |
1585 WOODLAKE DR SUITE 100 |
| City | CHESTERFIELD |
| State | MO |
| Zip Code | 63017-5740 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841281870 | Thomas F Hastings | Internal Medicine | 1585 Woodlake Dr, Suite 100, Chesterfield, MO 63017-5740 | 2005-10-31 |
| 1518418516 | Ahcmo 1 LLC | Clinic/Center | 1585 Woodlake Dr, 104, Chesterfield, MO 63017-5740 | 2016-10-14 |
| 1093260176 | Woodlake Podiatry, LLC | Podiatrist | 1585 Woodlake Dr, 200, Chesterfield, MO 63017-5740 | 2016-08-18 |
| 1982069233 | Woodlake Podiatry | Podiatrist | 1585 Woodlake Dr, 200, Chesterfield, MO 63017-5740 | 2015-12-30 |
| 1396161840 | St. Louis Eye Institute, PC | Ophthalmology | 1585 Woodlake Dr, Suite 106, Chesterfield, MO 63017-5740 | 2014-03-07 |
| 1750728366 | Inna Rakhmanova | Physical Therapist | 1585 Woodlake Dr, Suite 214, Chesterfield, MO 63017-5740 | 2013-05-23 |
| 1942646609 | Danielle Nichole Engle | Chiropractor | 1585 Woodlake Dr, Chesterfield, MO 63017-5740 | 2013-05-21 |
| 1023396256 | Elizabeth Anne Johnson | Physical Therapist | 1585 Woodlake Dr, Suite 214, Chesterfield, MO 63017-5740 | 2011-07-21 |
| 1740416650 | Alysia Shirell Brown | Nurse Practitioner | 1585 Woodlake Dr, Ste 104, Chesterfield, MO 63017-5740 | 2009-06-05 |
| 1265696777 | Leland Jaffe | Podiatrist | 1585 Woodlake Dr, Suite 200, Chesterfield, MO 63017-5740 | 2008-07-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114549193 | Kathryn E Bos | Student in an Organized Health Care Education/Training Program | 873 Apt N Foxsprings Dr, Chesterfield, MO 63017 | 2020-05-12 |
| 1700415171 | Charles H. Edwards | Physical Therapist | 224 South Woods Millrd., Suite 610 South, Chesterfield, MO 63017 | 2020-04-07 |
| 1003454562 | Stephanie Henningsen | Physical Therapy Assistant | 307 S Woods Rd, Chesterfield, MO 63017 | 2019-12-16 |
| 1831746296 | Star Lynn Sutton | Occupational Therapy Assistant | 15207 Olive Boulevard, Chesterfield, MO 63017 | 2019-08-21 |
| 1639738438 | Van Amburg & Busiek Md's, LLC | Pharmacy | 232 S Woodsmill Road, Suite 330 East, Chesterfield, MO 63017 | 2019-06-06 |
| 1306306865 | Margaret Mary Wynn | Nurse Practitioner | 15740 South Outer Road, Chesterfield, MO 63017 | 2019-03-21 |
| 1205393089 | Kimberly Danielle | Nurse Practitioner | 744 Forest Trace Dr, Chesterfield, MO 63017 | 2019-02-27 |
| 1457823965 | Allison Joy Mcgrail | Dietitian, Registered | 45740 S Outer Forty Rd, Chesterfield, MO 63017 | 2018-12-21 |
| 1316418080 | Julie Lefere | Social Worker | Mercy Virtual Care Center, 15740 S Outer 40 Rd, Chesterfield, MO 63017 | 2018-12-06 |
| 1336629641 | Catherine Dolphin Smith | Nurse Practitioner | 224 S Woods Mill Rd Ste 500, Chesterfield, MO 63017 | 2018-08-16 |
| Find all providers in zip 63017 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134756802 | Jennifer Nicole Clarke | Family Medicine | 8719 Corcoran Pl, Chesterfield, VA 23832-7463 | 2020-03-24 |
| 1467002717 | E Carter Enterprises | Family Medicine | 13506 Blue Heron Cir, Chesterfield, VA 23838-3258 | 2019-09-18 |
| 1205337417 | Vitalcare Family LLC | Family Medicine | 7300 Ashlake Parkway, Chesterfield, VA 23832 | 2018-02-22 |
| 1013368455 | Meghan Henningsen | Family Medicine | 17417 Chesterfield Airport Rd, Chesterfield, MO 63005-1308 | 2016-06-27 |
| 1831543826 | Leslie Noel Chanasue | Family Medicine | 17701 Edison Ave Ste 101, Chesterfield, MO 63005 | 2016-04-16 |
| 1497138663 | Rachel Vanessa Sachs | Family Medicine | 121 Saint Lukes Center Dr Ste 302, Chesterfield, MO 63017-3519 | 2015-07-07 |
| 1013273960 | Katherine Mary Marston | Family Medicine | 32901 23 Mile Road Suite 100, Chesterfield, MI 48047-4032 | 2012-04-04 |
| 1790018315 | Bayside Family Medicine Chesterfield PC | Family Medicine | 31225 23 Mile Rd, Chesterfield, MI 48047-1848 | 2009-09-14 |
| 1316115603 | Jeffery Allen Stynowick | Family Medicine | 130 Chippenham Ln, Chesterfield, MO 63005-6817 | 2008-02-20 |
| 1952582348 | Tu-van Tran | Family Medicine | 8407 Pullman Ln, Chesterfield, VA 23832-2076 | 2007-11-14 |
| Find all providers in CHESTERFIELD | ||||
| City | CHESTERFIELD |
| Zip Code | 63017 |
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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.