KELLY LYNN MUNSON (NPI# 1609427178) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609427178 |
| Entity Type | Individual |
| Full Name | KELLY LYNN MUNSON |
| Practice Address |
1 Jefferson Barracks Dr Lemay MO 63125-4181 |
| Mailing Address |
24 Brook Mill Ln Chesterfield MO 63017-8303 |
| Practice Telephone | 3142101909 |
| Mailing Telephone | 3143040379 |
| Enumeration Date | 2019-09-25 |
| Last Update Date | 2019-09-25 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2081P0004X |
Physical Medicine & Rehabilitation Specialization: Spinal Cord Injury Medicine |
2010023603 | MO | Allopathic & Osteopathic Physicians |
| Street Address |
1 JEFFERSON BARRACKS DR |
| City | LEMAY |
| State | MO |
| Zip Code | 63125-4181 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396396990 | Linda Marie Monken | Technician | 3792 Southern Manor, St. Louis, MO 63125 | 2019-09-25 |
| 1194373688 | Angel Angelette Rochelle Ellington | Technician | Va St Louis Spinal Cord Injury Unit, 1 Jefferson Barracks Drive 128/jb, St Louis, MO 63125 | 2019-08-28 |
| 1760940209 | Lea-ed Inc | Community Based Residential Treatment Facility, Mental Illness | 30 Sherman Road, Lemay, MO 63125 | 2019-03-04 |
| 1861957185 | Mary M Ross | Occupational Therapist | Sherbrooke Village, 4005 Ripa Ave, St. Louis, MO 63125 | 2019-02-01 |
| 1013400977 | Anne Henry Francis | Dietitian, Registered | Va St. Louis Health Care System, 1 Jefferson Barracks Drive, St. Louis, MO 63125 | 2018-06-14 |
| 1922458660 | Rebecca Mae Waugh | Skilled Nursing Facility | 1001 Holy Grail Ct, Saint Louis, MO 63125 | 2016-06-14 |
| 1942661814 | Dsk Works LLC | Chiropractor | 3193 Lemay Ferry Rd., Saint Louis, MO 63125 | 2016-03-18 |
| 1467717678 | Despine Louise Coulis | Pediatrics | 7545 S Lindbergh Blvd Ste 220, Saint Louis, MO 63125 | 2012-07-13 |
| 1184914194 | Allison Celeste Cassidy | Pharmacist | 3901 Lemay Ferry Road, Saint Louis, MO 63125 | 2011-04-11 |
| 1093049694 | Lauren C Mensie | Psychologist | 1 Jefferson Barracks Dr., 116b/jb St. Louis Va Medical Center, St. Louis, MO 63125 | 2009-09-29 |
| Find all providers in zip 63125 | ||||
| Taxonomy Code | 2081P0004X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Physical Medicine & Rehabilitation |
| Specialization | Spinal Cord Injury Medicine |
| A physician who addresses the prevention, diagnosis, treatment and management of traumatic spinal cord injury and non-traumatic etiologies of spinal cord dysfunction by working in an interdisciplinary manner. Care is provided to patients of all ages on a lifelong basis and covers related medical, physical, psychological and vocational disabilities and complications. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source added] Additional Resources: American Board of Physical Medicine and Rehabilitation, 2007. http://www.abpmr.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Physical Medicine and Rehabilitation. ACGME Accredited Residency Program Requirements: 1 year of training with 3-5 years in relevant specialty for a total of 4-6 years. ABMS Approved Subspecialty Certificate: (Physical Medicine and Rehabilitation) |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639174659 | John D Mcgarry | Physical Medicine & Rehabilitation | 168 Industrial Dr, Medical Village Annex Building, Festus, MO 63028-4133 | 2005-06-16 |
| 1811332380 | Jeffrey Michael Derbas | Physical Medicine & Rehabilitation | 6420 Clayton Rd, Saint Louis, MO 63117 | 2013-05-09 |
| 1952321580 | Pamela Sue Harris | Physical Medicine & Rehabilitation | 1500 Meadow Lake Pkwy Ste 200, Kansas City, MO 64114-1615 | 2006-07-19 |
| 1013972702 | Jai S Park | Physical Medicine & Rehabilitation | 1 Jefferson Barracks Dr, Saint Louis, MO 63125-4181 | 2006-04-18 |
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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.