PROFESSIONAL IMAGING LLC (NPI# 1619081940) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619081940 |
| Entity Type | Organization |
| Organization Name | PROFESSIONAL IMAGING LLC |
| Practice Address |
777 S New Ballas Rd Suite 005 Saint Louis MO 63141-8705 |
| Mailing Address |
Po Box 795180 St Louis MO 63179 |
| Practice Telephone | 3147432000 |
| Practice Fax Number | 3147432005 |
| Mailing Telephone | 3147432000 |
| Mailing Fax Number | 3147432005 |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2008-04-20 |
| Authorized Official Name | JON P HENDRICKS (MANAGER) |
| Authorized Official Telephone | 3148922598 |
| Authorized Official Credential | DC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2085B0100X |
Radiology Specialization: Body Imaging |
Allopathic & Osteopathic Physicians | ||
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AETNA | 7935693 | 01 | |
| HEALTHLINK | 686591 | 01 | |
| MO | BCBS | 198695 | 01 |
| Street Address |
777 S NEW BALLAS RD SUITE 005 |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63141-8705 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265436711 | Robert Daniel Craig | Otolaryngology | 777 S New Ballas Rd, Ste 320e, Saint Louis, MO 63141-8789 | 2005-06-10 |
| 1124597844 | Hailey B Cronin | Pharmacist | 777 S New Ballas Rd, Saint Louis, MO 63141-8705 | 2018-11-26 |
| 1326588856 | Options In Pyhsical Therapy | Clinic/Center | 777 S New Ballas Rd, Suite 218e, Saint Louis, MO 63141-8705 | 2017-03-02 |
| 1730638958 | West County Pharmacy LLC | Pharmacy | 777 S New Ballas Rd, Saint Louis, MO 63141-8705 | 2016-09-29 |
| 1205290749 | Advanced Family Medicine, LLC | Nurse Practitioner | 777 S New Ballas Rd, Ste 100e, Saint Louis, MO 63141-8705 | 2016-04-11 |
| 1174984918 | Jessica Loverude | Speech-Language Pathologist | 777 S New Ballas Rd, Suite 328w, Saint Louis, MO 63141-8705 | 2016-03-07 |
| 1548637853 | Chilcutt & Steuterman, Dds, LLC | Clinic/Center | 777 S New Ballas Rd, Ste. 310 West, Saint Louis, MO 63141-8705 | 2015-08-24 |
| 1922425784 | Savita S Bhat Md LLC | Psychologist | 777 S New Ballas Rd, Suite 217e, Saint Louis, MO 63141-8705 | 2014-03-18 |
| 1467874982 | N & W Associates Inc | Physical Medicine & Rehabilitation | 777 S New Ballas Rd, Suite 302w, Saint Louis, MO 63141-8705 | 2014-01-17 |
| 1962767665 | Charles William Pelton | Optometrist | 777 S New Ballas Rd, Suite 218e, Saint Louis, MO 63141-8705 | 2012-07-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679102842 | Noor Ramadan | Pharmacist | 628 North New Ballad Road, Suite A, Creve Coeur, MO 63141 | 2020-04-08 |
| 1497381206 | Washington University | Durable Medical Equipment & Medical Supplies | 1044 North Mason Road, Suite 110/210, St. Louis, MO 63141 | 2020-03-13 |
| 1154956498 | Ashleigh Clendenny | Physician Assistant | Mercy Hospital St. Louis, 615 S New Ballas Rd, St. Louis, MO 63141 | 2020-03-06 |
| 1801429410 | Emili Lou Haley | Registered Nurse | 650 Maryville Drive, St Louis, MO 63141 | 2020-02-21 |
| 1629553110 | Rebecca Kathleen Pike | Social Worker | West County Psychological Associates, 12125 Woodcrest Executive Drive #110, St. Louis, MO 63141 | 2018-10-01 |
| 1649756099 | River City Sedation Associates, LLC | Nurse Anesthetist, Certified Registered | 12855 N 40 Dr Ste 150, Saint Louis, MO 63141 | 2018-07-18 |
| 1205333952 | Ear Care and Hearing of St. Louis | Hearing Aid Equipment | 11630 Studt Ave Ste 210, Creve Coeur, MO 63141 | 2018-04-10 |
| 1659897486 | Erin Goodman | Physical Therapist | 10560 Old Olive St. Rd, Suite 100, Creve Coeur, MO 63141 | 2017-08-14 |
| 1093230450 | Center for Urologic Surgery LLC | Clinic/Center | 12855 N 40 Dr Ste 100, Saint Louis, MO 63141 | 2017-08-07 |
| 1871016105 | Jacob Farley Tanner | Specialist/Technologist | 1054 Town and Four Parkway Dr, Creve Coeur, MO 63141 | 2017-07-19 |
| Find all providers in zip 63141 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609130566 | Kristin Harris Drake | Radiology | 621 S New Ballas Rd Ste 23a, Saint Louis, MO 63141 | 2012-06-26 |
| 1093083016 | William G Crawford | Radiology | 61 Crestwood Dr, Saint Louis, MO 63105-3020 | 2011-12-05 |
| 1558657643 | Joseph Gary Livingston | Radiology | One Barnes-jewsih Hospital Plaza, Mailstop 90-09-355, Saint Louis, MO 63110 | 2011-06-27 |
| 1013219344 | Pure Imaging LLC | Radiology | 12345 West Bend Drive, Saint Louis, MO 63128-2104 | 2010-11-18 |
| 1881884658 | Zhengming Gu | Radiology | 9240 Radiom Dr, Saint Louis, MO 63123-5545 | 2007-07-27 |
| 1306057310 | Mohammed Ali Abbas | Radiology | 1402 S Grand Blvd Rm 260, Saint Louis, MO 63104-1004 | 2007-05-24 |
| 1104040963 | Saadoon Kadir | Radiology | 2909 Netherton Dr, Saint Louis, MO 63136-4677 | 2007-04-12 |
| 1376612739 | Carl Joseph Aschkenasi | Radiology | 898 Alanson Dr, Saint Louis, MO 63132-5039 | 2006-11-07 |
| 1629182829 | Jeffery A Hardy | Radiology | 2344 Hampton Ave, Saint Louis, MO 63139-2909 | 2006-08-18 |
| 1124132436 | Alfred D Shaplin | Radiology | 1034 S Brentwood Blvd Ste 280, Saint Louis, MO 63117-1221 | 2006-08-17 |
| Find all providers in SAINT LOUIS | ||||
| City | SAINT LOUIS |
| Zip Code | 63141 |
Please comment or provide details below to improve the information on PROFESSIONAL IMAGING LLC.
| 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.