IDIM (NPI# 1588912448) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588912448 |
| Entity Type | Organization |
| Organization Name | IDIM |
| Practice Address |
1909 Larimer Trl Wildwood MO 63011-4801 |
| Practice Telephone | 6362735311 |
| Mailing Telephone | 6362735311 |
| Enumeration Date | 2012-08-27 |
| Last Update Date | 2012-11-16 |
| Authorized Official Name | ALEXANDRE LACASSE (PRESIDENT) |
| Authorized Official Telephone | 6362735311 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RI0200X |
Internal Medicine Specialization: Infectious Disease |
2006028227 | MO | Allopathic & Osteopathic Physicians |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | IDIMAGINE INCORPORATED | 11820 Northup Way Ste E 200, Bellevue, WA 98005 |
| Washington State Corporations | IDIMENSIONAL LLC | 2410 W Manor Pl Apt 506, Seattle, WA 98199-2025 |
| Street Address |
1909 LARIMER TRL |
| City | WILDWOOD |
| State | MO |
| Zip Code | 63011-4801 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205309234 | Heather Renee Leone | Nurse Practitioner | 452 Sovereign Court Suite A, Ballwin, MO 63011 | 2019-01-02 |
| 1538635297 | Jennifer Lea Nicole O'donnell | Registered Nurse | 13861 Manchester Road, Town and Country, MO 63011 | 2018-10-22 |
| 1285127712 | Genevieve Friedmann | Social Worker | 301 Sovereign Ct Ste 103, Ballwin, MO 63011 | 2018-06-09 |
| 1881187391 | Andrew Cittadino Link | Dentist | 14335 Manchester Road, Ballwin, MO 63011 | 2018-06-08 |
| 1972041283 | Anavan LLC | Durable Medical Equipment & Medical Supplies | 14390 Manchester Rd, Saint Louis, MO 63011 | 2017-02-07 |
| 1780131300 | Autism and Behavioral Spectrum LLC | Day Training, Developmentally Disabled Services | 14733 Clayton Road, Chesterfield, MO 63011 | 2016-09-01 |
| 1265872964 | Eryn Nichole Miner | Behavioral Analyst | 15834 Clayton Road, Ellisville, MO 63011 | 2013-06-27 |
| 1194168765 | Donna Margaret Carrillo | Developmental Therapist | 15834 Clayton Rd., Ellisville, MO 63011 | 2013-04-12 |
| 1891047486 | Ashley Amanda Battaglia | Chiropractor | 15945 Clayton Rd Ste 230c, Ballwin, MO 63011 | 2012-10-08 |
| 1750658480 | Gary Frank Sobocinski | Pharmacist | 4033 Sovereign Court, Ballwin, MO 63011 | 2011-11-23 |
| Find all providers in zip 63011 | ||||
| Taxonomy Code | 207RI0200X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Infectious Disease |
| An internist who deals with infectious diseases of all types and in all organ systems. Conditions requiring selective use of antibiotics call for this special skill. This physician often diagnoses and treats AIDS patients and patients with fevers which have not been explained. Infectious disease specialists may also have expertise in preventive medicine and travel medicine. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598242778 | Metro Infectious Disease Consultants, LLC | Internal Medicine | 2340 E Meyer Blvd Ste 348, Kansas City, MO 64132-1129 | 2018-07-20 |
| 1396284303 | Southwest Missouri Infectious Disease LLC | Internal Medicine | 2872 S Forrest Heights Ave, Springfield, MO 65809-3417 | 2017-02-23 |
| 1194125195 | West County Infectious Disease, LLC | Internal Medicine | 16918 Westridge Oaks Dr, Grover, MO 63040-1127 | 2014-08-26 |
| 1306188784 | Rachel T Weihe | Internal Medicine | 200 Ne 54th Street, Suite 111, Kansas City, MO 64118 | 2013-03-22 |
| 1548524218 | Blessy John | Internal Medicine | 2115 S Fremont Ave Ste 3050, Springfield, MO 65804-2236 | 2012-06-27 |
| 1346532769 | Malcolm Koldin | Internal Medicine | 13 Autumn Shores Ct, Maryland Heights, MO 63043-4913 | 2011-05-03 |
| 1528246071 | Rajashree Gottimukkula | Internal Medicine | 3691 Rutger St Ste 100, Drummond Hall, Saint Louis, MO 63110-2515 | 2008-02-07 |
| 1497943393 | West County Adult Medicine, LLC | Internal Medicine | 224 S Woods Mill Rd Ste 510s, Chesterfield, MO 63017-3611 | 2007-10-05 |
| 1881885044 | Getahun Abate | Internal Medicine | 1100 S. Grand Blvd., Drc-8th Floor, Saint Louis, MO 63104-3325 | 2007-08-05 |
| 1174742753 | Qual-t-med, Inc | Internal Medicine | 1501 Hampton Ave, Saint Louis, MO 63139-3038 | 2007-04-24 |
| Find all providers with the same taxonomy | ||||
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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.