JAMES A PETTERCHAK (NPI# 1598832032) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598832032 |
| Entity Type | Individual |
| Full Name | JAMES A PETTERCHAK |
| Credential | MD |
| Practice Address |
3015 N. Ballas Dept of Pathology St. Louis MO 63131 |
| Practice Telephone | 3149965551 |
| Practice Fax Number | 3149965551 |
| Mailing Telephone | 3149965551 |
| Mailing Fax Number | 3149965551 |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2008-10-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207ZF0201X |
Pathology Specialization: Forensic Pathology |
036-101883 | IL | Allopathic & Osteopathic Physicians |
| N | 207ZP0101X |
Pathology Specialization: Anatomic Pathology |
036-101883 | IL | Allopathic & Osteopathic Physicians |
| N | 207ZP0105X |
Pathology Specialization: Clinical Pathology/Laboratory Medicine |
036-101883 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 1598832032 | 05 |
| Street Address |
3015 N. BALLAS DEPT OF PATHOLOGY |
| City | ST. LOUIS |
| State | MO |
| Zip Code | 63131 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568097954 | Avalcare Inc | Pharmacy | 10431 Clayton Rd, Saint Louis, MO 63131 | 2020-03-06 |
| 1891331369 | Life Clinic of Mo Dc PC | Chiropractor | 2051 South Lindbergh Blvd, Frontenac, MO 63131 | 2019-11-20 |
| 1447892542 | Jand. Inc. | Eyewear Supplier (Equipment, not the service) | 30 S Lindbergh Blvd, Saint Louis, MO 63131 | 2019-10-10 |
| 1336797026 | Justa Davis | Dietitian, Registered | 3015 North Ballas, Saint Louis, MO 63131 | 2019-08-27 |
| 1730695362 | Curators of The University of Missouri | Psychologist | 12837 Flushing Meadows Drive, Sutie 220, Town and Country, MO 63131 | 2017-12-19 |
| 1770012031 | Danielle Marie Hargate | Specialist/Technologist | 732 Timber Trail, Frontenac, MO 63131 | 2017-06-08 |
| 1285087429 | Kathryn Parker | Internal Medicine | 1000 Des Peres Rd Ste 300, Saint Louis, MO 63131 | 2016-07-22 |
| 1437524360 | Julie Ann Godefroid | Nurse Practitioner | 1010 Old Des Peres Road, St. Louis, MO 63131 | 2015-12-03 |
| 1073982435 | Rebecca Baum Rainbolt | Social Worker | 12210 Clayton Rd, Saint Louis, MO 63131 | 2015-09-16 |
| 1518217322 | Advanced Anesthesia and Pain Management, LLC | Anesthesiology | 12805 Topping Woods Estate Drive, St. Louis, MO 63131 | 2012-09-19 |
| Find all providers in zip 63131 | ||||
| Taxonomy Code | 207ZF0201X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pathology |
| Specialization | Forensic Pathology |
| A forensic pathologist is expert in investigating and evaluating cases of sudden, unexpected, suspicious and violent death as well as other specific classes of death defined by law. The forensic pathologist serves the public as coroner or medical examiner, or by performing medicolegal autopsies for such officials. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pathology, 2007. http://www.abpath.org/. American Osteopathic Board of Pathology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pathology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pathology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790980522 | Kamal Deep Sabharwal | Pathology | 6039 Helen Ave, Saint Louis, MO 63134-2013 | 2007-06-20 |
| 1982624938 | Thomas William Young | Pathology | 660 E 24th St, Kansas City, MO 64108-2606 | 2006-07-20 |
| 1023065406 | Charles W Caldwell | Pathology | 1013 Marcassin Dr, Columbia, MO 65201-7196 | 2006-05-30 |
| 1053767517 | Marius Calin Tarau | Pathology | 950 E 21st St, Kansas City, MO 64108-2703 | 2016-05-13 |
| 1487071668 | Irfan Chaudhry | Pathology | 2301 Holmes St, Kansas City, MO 64108-2640 | 2014-03-25 |
| 1760722763 | Boguslaw Robert Pietak | Pathology | 660 E 24th St, Kansas City, MO 64108-2606 | 2013-02-27 |
| 1164680369 | Keith Norman Norton | Pathology | One Hospital Dr, Columbia, MO 65212-0001 | 2008-05-26 |
| 1477747459 | Mary Helen Dudley | Pathology | 660 E 24th St, Kansas City, MO 64108-2606 | 2007-08-31 |
| 1760556146 | Carl Christopher Stacy | Pathology | One Hospital Drive, Columbia, MO 65212-0001 | 2006-11-20 |
| 1366456840 | Edward Stephen Bolesta | Pathology | 1402 S Grand, St Louis, MO 63104 | 2006-07-28 |
| 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.