DR. COURTNEY CHAMPAGNE CRIDER (NPI# 1598146557) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598146557 |
| Entity Type | Individual |
| Full Name | DR. COURTNEY CHAMPAGNE CRIDER |
| Other Name | MS. COURTNEY RUE CHAMPAGNE |
| Credential | M.D. |
| Practice Address |
201 Bjc Saint Peters Dr Ste 100 Saint Peters MO 63376-3386 |
| Practice Telephone | 6369168200 |
| Practice Fax Number | 6369465774 |
| Mailing Telephone | 6369168200 |
| Mailing Fax Number | 6369465774 |
| Enumeration Date | 2015-06-16 |
| Last Update Date | 2019-07-11 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | 2019014137 | MO | Allopathic & Osteopathic Physicians |
| N | 207N00000X | Dermatology | 2015017799 | MO | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1755 S. Grand Blvd., Slu Dermatology Residency Program, Saint Louis, MO 63104 | 3142563400 |
| Street Address |
201 BJC SAINT PETERS DR STE 100 |
| City | SAINT PETERS |
| State | MO |
| Zip Code | 63376-3386 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184042855 | Keith Wickenhauser | Internal Medicine | 201 Bjc Saint Peters Dr Ste 100, Saint Peters, MO 63376 | 2014-03-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275047946 | Nicholas Christian Schultz | Dentist | 100 Piper Hill Dr Ste A, Saint Peters, MO 63376 | 2017-11-16 |
| 1982120093 | Carol Weber | Speech-Language Pathologist | 166 Boone Hills Dr., St Peters, MO 63376 | 2017-08-21 |
| 1619424744 | Forefront Dermatology, S.c. | Dermatology | 5700 Mexico Rd, Suite 14, Saint Peters, MO 63376 | 2016-09-07 |
| 1508310632 | Preferred Family Healthcare, Inc. | Counselor | 2120 Parkway Dr, Saint Peters, MO 63376 | 2016-08-05 |
| 1598130676 | Delta Center Personal Attendant Services | In Home Supportive Care | 3833 Mcclay, Suite 61, St. Peters, MO 63376 | 2015-12-01 |
| 1427420314 | Barbara Marlene Edelman | Counselor | 1286 Jungerman Rd. Suite G, St. Peters, MO 63376 | 2015-10-30 |
| 1255740247 | Claire Williams | Dentist | 340 Mid Rivers Mall Drive, Suite E, St. Peters, MO 63376 | 2014-08-05 |
| 1821415233 | Abby Link | Physician Assistant | 107 Piper Parkway, #150, St. Peters, MO 63376 | 2014-03-24 |
| 1225452105 | Ashley Gagel | Physical Therapist | 7055 Mexico Rd Suite 1601, St. Peters, MO 63376 | 2014-02-12 |
| 1083052591 | Sarah Linn | Social Worker | 1236 Jungermann Rd Ste D, Saint Peters, MO 63376 | 2013-06-06 |
| Find all providers in zip 63376 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982968103 | Nora K Shumway | Dermatology | 201bjc St. Peters Dr, Suite 1a, Saint Peters, MO 63376-3385 | 2012-07-02 |
| 1134547656 | Paul Gruber | Dermatology | 5700 Mexico Rd Ste 14, Saint Peters, MO 63376-1667 | 2014-04-01 |
| 1790072395 | Kyle J Eash | Dermatology | 5700 Mexico Rd Ste 14, Saint Peters, MO 63376-1667 | 2011-07-02 |
| 1063443588 | Scott C Carrizales | Dermatology | 70 Jungermann Cir, Saint Peters, MO 63376-1622 | 2006-07-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922605906 | Deluxe Dermatology LLC | Dermatology | 1034 S Brentwood Blvd Ste 1000, Saint Louis, MO 63117-1210 | 2020-10-03 |
| 1811510886 | Yoon Dermatology LLC | Dermatology | 1060 Meyer Rd, Wentzville, MO 63385-3800 | 2020-05-25 |
| 1417597923 | Anna Marie Aiazzi | Dermatology | 10012 Kennerly Rd Ste 401, Saint Louis, MO 63128-2197 | 2020-01-13 |
| 1790330371 | Baydon Earl Hilton | Dermatology | 1003 Kings Rd, Kirksville, MO 63501-2627 | 2019-08-09 |
| 1467912550 | Ian Ferguson | Dermatology | 660 S Euclid Ave., Cb 8123, St. Louis, MO 63110 | 2019-03-23 |
| 1528537057 | Cayce Medical Spa, Inc | Dermatology | 2001 Corona Rd Ste 201, Columbia, MO 65203-5924 | 2018-11-14 |
| 1396226981 | Nicole Betty | Dermatology | 413 W Water Street, Greenfield, MO 65661 | 2018-08-22 |
| 1366946832 | Novahealth Medical Group, LLC | Dermatology | 3208 Lemone Industrial Blvd Ste A, Columbia, MO 65201-8244 | 2018-03-20 |
| 1952757007 | Stacy Gittel Blum | Dermatology | 222 S Woods Mill Rd Ste 480, Chesterfield, MO 63017-3625 | 2016-05-08 |
| 1508248576 | Kaitlin Ann Schiavo | Dermatology | 204 N Keene St Ste 100, Columbia, MO 65201-8136 | 2015-06-25 |
| Find all providers with the same taxonomy | ||||
| City | SAINT PETERS |
| Zip Code | 63376 |
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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.