PEDIATRIC NEURODEVELOPMENTAL CENTER LLC (NPI# 1639500192) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639500192 |
| Entity Type | Organization |
| Organization Name | PEDIATRIC NEURODEVELOPMENTAL CENTER LLC |
| Practice Address |
17300 N Outer 40 Rd Suite 205 Chesterfield MO 63005-1364 |
| Practice Telephone | 6367789212 |
| Mailing Telephone | 6367789212 |
| Enumeration Date | 2013-12-10 |
| Last Update Date | 2013-12-10 |
| Authorized Official Name | DR. AVI E. DOMNITZ-GEBET (AUTHORIZED REP/ OWNER/ MD) |
| Authorized Official Telephone | 6367789212 |
| Authorized Official Credential | D.O. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians |
| Street Address |
17300 N OUTER 40 RD SUITE 205 |
| City | CHESTERFIELD |
| State | MO |
| Zip Code | 63005-1364 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396728002 | Matthew Christian Bayes | Pediatrics | 17300 N Outer 40 Rd, Suite 201, Chesterfield, MO 63005-1364 | 2005-11-28 |
| 1467073742 | Key Anesthesia Partners | Nurse Anesthetist, Certified Registered | 17300 N Outer 40 Rd, Chesterfield, MO 63005-1375 | 2020-04-28 |
| 1578917126 | Jessica Aschwege | Physical Therapist | 17300 N Outer 40 Rd, Suite 202, Chesterfield, MO 63005-1375 | 2016-04-20 |
| 1659784023 | Natalie Corzine | Behavioral Analyst | 17300 N Outer 40 Rd, Chesterfield, MO 63005-1364 | 2014-06-03 |
| 1891114526 | Michael V Oliveri | Clinical Neuropsychologist | 17300 N Outer 40 Rd, Suite 203, Chesterfield, MO 63005-1364 | 2014-04-09 |
| 1487076485 | Missouri Center for Reproductive Medicine, LLC | Obstetrics & Gynecology | 17300 N Outer 40 Rd, Suite 101, Chesterfield, MO 63005-1364 | 2014-01-09 |
| 1821423385 | Excel Orthopedics LLC | Orthopaedic Surgery | 17300 N Outer 40 Rd, Suite 316, Chesterfield, MO 63005-1375 | 2013-09-03 |
| 1285986398 | Bluetail Medical Group, LLC. | Orthopaedic Surgery | 17300 N Outer 40 Rd, Suite 201, Chesterfield, MO 63005-1375 | 2012-10-12 |
| 1427315431 | Michael Joseph Backer | Student in an Organized Health Care Education/Training Program | 17300 N Outer 40 Rd, Suite 103, Chesterfield, MO 63005-1375 | 2012-04-15 |
| 1154622926 | Erin Berkow Seltzer | Counselor | 17300 N Outer 40 Rd, Suite 212, Chesterfield, MO 63005-1364 | 2010-11-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063901254 | Ryan Hewkin | Chiropractor | 17684 Chesterfield Airport Road, Chesterfield, MO 63005 | 2018-05-03 |
| 1093224487 | All Family Matters, LLC | In Home Supportive Care | 100 Chesterfield Business Pkwy Ste 200, Chesterfield, MO 63005 | 2017-09-28 |
| 1437681293 | Emily Therese Harpel | Pharmacist | 691 Trade Center Blvd, Chesterfield, MO 63005 | 2017-03-31 |
| 1831543826 | Leslie Noel Chanasue | Family Medicine | 17701 Edison Ave Ste 101, Chesterfield, MO 63005 | 2016-04-16 |
| 1497112874 | Jordan Kimler | Nurse Practitioner | 124 Chesterfield Towne Ctr, Chesterfield, MO 63005 | 2016-01-15 |
| 1265850556 | Richard George Rougeau | General Practice | 17679 Wildridge Drive, Wildwood, MO 63005 | 2014-04-03 |
| 1679912554 | Ceara M Barmeier | Physician Assistant | 17300 N Outer 40 Rd #101, Chesterfield, MO 63005 | 2013-06-24 |
| 1265794911 | Regeneration Orthopedics, LLC | Anesthesiology | 6 Mcbride & Son Center Dr., Ste 204, Chesterfield, MO 63005 | 2012-06-08 |
| 1528334984 | Syed Tanveer Haider | Radiologic Technologist | 16502 Barrister Lane, Chesterfield, MO 63005 | 2012-03-29 |
| 1144591041 | Sensible Dental - Chesterfield | Dentist | 100 Thf Blvd., Chesterfield, MO 63005 | 2012-01-24 |
| Find all providers in zip 63005 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| 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 Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154550630 | Kora Nicole Felsch | Pediatrics | 226 S Woods Mill Rd 32w, Chesterfield, MO 63017 | 2009-07-06 |
| 1740491141 | Kathryn Kerr Wade | Pediatrics | 13001 N Outer 40 Rd Ste 310, Ste 310, Chesterfield, MO 63017-5941 | 2007-05-25 |
| 1265656193 | Rosita Justo Guzon | Pediatrics | 1343 Conway Oaks Dr, Chesterfield, MO 63017-1960 | 2007-04-12 |
| 1164594883 | Santosh Gupta | Pediatrics | 16216 Baxter Road Suite 299, Chesterfield, MO 63017 | 2006-11-15 |
| 1073603189 | Robert James Profumo | Pediatrics | 1308 Westchester Manor Ln, Chesterfield, MO 63005-4355 | 2006-10-13 |
| 1215046263 | Julia M Mayer | Pediatrics | 226 S Woods Mill Rd Ste 32w, Chesterfield, MO 63017-3442 | 2006-08-30 |
| 1053351338 | Mohamad Al-hosni | Pediatrics | 14443 White Birch Valley Ln, Chesterfield, MO 63017-2415 | 2006-06-07 |
| 1104891274 | Anna P Huger | Pediatrics | 13001 N Outer 40 Rd Ste 330, Chesterfield, MO 63017-5941 | 2006-02-21 |
| 1154302131 | David E Hartenbach | Pediatrics | 13001 N Outer 40 Rd Ste 320, Chesterfield, MO 63017-5941 | 2005-11-08 |
| 1083601819 | Janet G Mueller | Pediatrics | 13001 N Outer 40 Rd, Ste 340, Chesterfield, MO 63017-5941 | 2005-10-06 |
| Find all providers in CHESTERFIELD | ||||
| City | CHESTERFIELD |
| Zip Code | 63005 |
Please comment or provide details below to improve the information on PEDIATRIC NEURODEVELOPMENTAL CENTER 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.