DR. CAROLYN ANNE SMITH (NPI# 1649298076) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649298076 |
| Entity Type | Individual |
| Full Name | DR. CAROLYN ANNE SMITH |
| Credential | MD |
| Practice Address |
13303 Tesson Ferry Rd Ste 150 Saint Louis MO 63128 |
| Mailing Address |
Po Box 23340 Saint Louis MO 63156-3340 |
| Practice Telephone | 3148425239 |
| Practice Fax Number | 3148423835 |
| Mailing Telephone | 3148511000 |
| Mailing Fax Number | 3148514445 |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2019-03-15 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 2003010764 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 208819607 | 05 | |
| IL | ENROLLED | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1 Childrens Pl, Ste 5s20, Saint Louis, MO 631101002 | 3144546148 | 3144544633 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245889773 | Carolyn Dianne Smith | Technician | 14077 Felton Rd, Gulfport, MS 39503-5131 | 2019-09-06 |
| 1225521917 | Carolyn Ann Smith | Home Health Aide | 13755 New Halls Ferry Rd, Florissant, MO 63033-3028 | 2018-06-07 |
| 1164911079 | Carolyn J Smith | Behavior Technician | 306 S Mason St, Bensenville, IL 60106-2682 | 2018-05-07 |
| 1174062319 | Carolyn Diane Smith | Registered Nurse | 2305 Springhill Ln, Lindenhurst, IL 60046-8326 | 2017-02-21 |
| 1538539580 | Carolyn Smith | Counselor | 13919 Carrollwood Village Run, Tampa, FL 33618-2746 | 2015-10-02 |
| 1649657230 | Carolyn Marian Smith | Nurse Practitioner | 1000 Morris Ave # Dn-126a, Union, NJ 07083-7133 | 2015-05-03 |
| 1962646786 | Carolyn Marion Smith | Clinic/Center | 3620 N Lauren Ln, Bloomington, IN 47404-9206 | 2009-04-23 |
| 1124226824 | Carolyn M Smith | Pharmacist | 43 Sabin St Quad Bldg Rm Qe 213, Charleston, SC 29245 | 2007-07-05 |
| 1750585063 | Carolyn R Smith | Nurse Practitioner | 326 South Side Road, Bee Branch, AR 72013-9137 | 2007-06-12 |
| 1154538460 | Carolyn Smith | Case Manager/Care Coordinator | 1500 Kanakanak Road, Dillingham, AK 99576-0310 | 2007-05-17 |
| Street Address |
13303 TESSON FERRY RD STE 150 |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63128 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790922623 | Suzanne L. Jaudes | Nurse Practitioner | 13303 Tesson Ferry Rd Ste 150, Saint Louis, MO 63128 | 2009-01-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235771155 | James T Fetsch Dmd LLC | Dentist | 10004 Kennerly Rd Suite 240, Saint Louis, MO 63128 | 2019-10-11 |
| 1326504655 | Nikodem Dental Holdings | Dentist | 4337 Butler Hill Rd Suite G, St Louis Mo, MO 63128 | 2019-02-12 |
| 1932678505 | Michelle Anne Arvidson | Physical Therapy Assistant | Elite Physical Therapy, 12608 Lamplighter Square Shopping Center, St. Louis, MO 63128 | 2018-11-13 |
| 1245726710 | Kristen Rider | Nurse Practitioner | 9964 Kennerly Rd Ste D, Saint Louis, MO 63128 | 2018-07-07 |
| 1306217427 | Sophia Bednarski | Dentist | 12660 Lamplighter Square Shopping Center, St. Louis, MO 63128 | 2015-10-15 |
| 1427434224 | Darcie Burrus | Counselor | 12523 Old Tesson Rd G, St Louis, MO 63128 | 2015-08-04 |
| 1710368584 | Sara Hawatmeh | Internal Medicine | 12345 W Bend Dr Ste 304, Saint Louis, MO 63128 | 2015-06-17 |
| 1871989590 | Celia Grace Montes-kolence | Speech-Language Pathologist | 12335 W Bend Drive, Saint Louis, MO 63128 | 2015-04-09 |
| 1245629302 | Marius Antonio Evans | Dentist | 9911 Kennerly Rd., Suite G, St. Louis, MO 63128 | 2015-01-13 |
| 1801230313 | Sarah Elizabeth Walsh | Emergency Medicine | 10010 Kennerly Road, Emergency Department, St. Anthony's Medical Center, St. Louis, MO 63128 | 2013-04-26 |
| Find all providers in zip 63128 | ||||
| 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 |
|---|---|---|---|---|
| 1538786413 | Melissa An | Pediatrics | 1 Childrens Pl Ste 3s36, Saint Louis, MO 63110-1002 | 2020-06-26 |
| 1538795547 | Virtualnicu | Pediatrics | 10 Warridge Dr, Saint Louis, MO 63124-1166 | 2020-03-21 |
| 1174082887 | Kristen Steinmeyer | Pediatrics | 714 Peace Haven Ct, Saint Louis, MO 63125-5404 | 2019-03-13 |
| 1487149498 | Jessica Sims | Pediatrics | 1 Childrens Pl Ste 3s34, Saint Louis, MO 63110-1002 | 2018-06-22 |
| 1356835342 | Jerome Michael Molleston | Pediatrics | 1 Childrens Pl Cb8116, Saint Louis, MO 63110-1081 | 2018-06-21 |
| 1598259566 | Kylie Bushroe | Pediatrics | 1 Childrens Pl Ste 3n18, Saint Louis, MO 63110-1081 | 2018-06-21 |
| 1710492228 | Ideal Pediatric Wellness, LLC | Pediatrics | 10007 Kennerly Rd Ste C, Saint Louis, MO 63128-2179 | 2017-12-06 |
| 1578083424 | Michael Quinn | Pediatrics | Wusm Peds Infectious Diseases, 1 Childrens Pl Cb 8116, Saint Louis, MO 63110-1002 | 2017-06-21 |
| 1205367612 | Anchal Sethi | Pediatrics | 1234 S Kingshighway Blvd Ste 1200, Saint Louis, MO 63110-2170 | 2017-03-27 |
| 1831541895 | Lila Sarah Wahidi Nolan | Pediatrics | Wusm Peds Newborn Medicine, 1 Childrens Pl Cb 8116, Saint Louis, MO 63110 | 2016-07-01 |
| Find all providers in SAINT LOUIS | ||||
| City | SAINT LOUIS |
| Zip Code | 63128 |
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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.