ST LOUIS UNIVERSITY (NPI# 1669691366) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669691366 |
| Entity Type | Organization |
| Organization Name | ST LOUIS UNIVERSITY |
| Other Organization Name | SLUCARE DEPT OF PSYCHIATRY-GERIATRIC PSYCHIATRY |
| Practice Address |
1438 S Grand Blvd Saint Louis MO 63104-1027 |
| Mailing Address |
1831 Chestnut St Ste 650 Saint Louis MO 63103-2236 |
| Practice Telephone | 3145778734 |
| Mailing Telephone | 3149776828 |
| Enumeration Date | 2007-04-24 |
| Last Update Date | 2019-06-20 |
| Authorized Official Name | ALYCE LANXON (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 3149776828 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0805X |
Psychiatry & Neurology Specialization: Geriatric Psychiatry |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| SLUCARE DEPT OF PSYCHIATRY-GERIATRIC PSYCHIATRY | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487869863 | St Louis University | Eyewear Supplier (Equipment, not the service) | 1755 South Grand, St Louis, MO 63104 | 2007-05-11 |
| 1194892463 | St Louis University | Orthopaedic Surgery | 1831 Chestnut St Ste 650, Saint Louis, MO 63103 | 2006-11-29 |
| 1093894842 | St Louis University | Internal Medicine | 10 Franklin, Washington, MO 63090 | 2006-11-03 |
| 1417035759 | St Louis University | Audiologist | 3750 Lindell, St Louis, MO 63108 | 2006-11-02 |
| 1992778237 | St Louis University | Urology | 3655 Vista Ave, Saint Louis, MO 63110-2539 | 2006-02-08 |
| 1164495412 | St Louis University | Pathology | 1402 South Grand, St Louis, MO 63104 | 2006-02-08 |
| 1801869136 | St Louis University | Psychiatry & Neurology | 1438 S Grand Blvd, Saint Louis, MO 63104-1027 | 2006-02-08 |
| 1740253095 | St Louis University | Dermatology | 1755 S Grand Blvd, Saint Louis, MO 63104-1540 | 2006-02-08 |
| 1184266413 | St Louis University | Pediatrics | 1465 S Grand Blvd, Saint Louis, MO 63104-1003 | 2019-10-08 |
| 1184908865 | St Louis University | Urology | 1465 S Grand Blvd, Saint Louis, MO 63104-1003 | 2011-09-29 |
| Street Address |
1438 S GRAND BLVD |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63104-1027 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801869136 | St Louis University | Psychiatry & Neurology | 1438 S Grand Blvd, Saint Louis, MO 63104-1027 | 2006-02-08 |
| 1477181071 | Kevin Chacko Varghese | Student in an Organized Health Care Education/Training Program | 1438 S Grand Blvd, Saint Louis, MO 63104-1027 | 2020-03-30 |
| 1609404201 | Allison Montgomery | Student in an Organized Health Care Education/Training Program | 1438 S Grand Blvd, Saint Louis, MO 63104-1027 | 2020-03-30 |
| 1457989055 | Marissa Alexandra Hirsch | Student in an Organized Health Care Education/Training Program | 1438 S Grand Blvd, Saint Louis, MO 63104-1027 | 2020-03-30 |
| 1366070963 | Rajat Duggirala | Student in an Organized Health Care Education/Training Program | 1438 S Grand Blvd, Saint Louis, MO 63104-1027 | 2020-03-30 |
| 1275161879 | Ellen Kim | Student in an Organized Health Care Education/Training Program | 1438 S Grand Blvd, Saint Louis, MO 63104-1027 | 2020-03-30 |
| 1184252785 | Derek Wayne Brown | Student in an Organized Health Care Education/Training Program | 1438 S Grand Blvd, Saint Louis, MO 63104-1027 | 2020-03-30 |
| 1619505591 | Farid Khasiyev | Student in an Organized Health Care Education/Training Program | 1438 S Grand Blvd, Saint Louis, MO 63104-1027 | 2020-03-27 |
| 1578190393 | Kelsey Roberts | Psychiatry & Neurology | 1438 S Grand Blvd, Saint Louis, MO 63104-1027 | 2020-03-23 |
| 1457912230 | Katherine Mcarthur | Student in an Organized Health Care Education/Training Program | 1438 S Grand Blvd, Saint Louis, MO 63104-1027 | 2019-06-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407469570 | Family Care Health Centers | Clinic/Center | 2717 Sidney Street, St. Louis, MO 63104 | 2020-08-28 |
| 1023638038 | Laura Ann Humphrey | Physician Assistant | Allied Health Building 3437 Caroline Street, Room 3015, Saint Louis, MO 63104 | 2020-04-20 |
| 1174187264 | Ahsan Ali | Student in an Organized Health Care Education/Training Program | 1438 South Grand Blvd, Monteleone Hall, St. Louis, MO 63104 | 2019-04-24 |
| 1205359916 | Brenda Eve Ladin | Behavior Technician | 1221 Allen Market Lane Rear, St. Louis, MO 63104 | 2017-07-25 |
| 1841722063 | Gustavo G Mendez | Student in an Organized Health Care Education/Training Program | 1465 South Grand Bulevard Rm 2717, Ssm Health Cardinal Glennon Children's Hospital, Saint Louis, MO 63104 | 2017-03-28 |
| 1053776716 | Carmella Harper | Respiratory Therapist, Certified | 2678 Park Ave, St Louis, MO 63104 | 2015-12-23 |
| 1922485986 | Alexander Tremont | Internal Medicine | 1402 S Grand Blvd Rm M260, Saint Louis, MO 63104 | 2015-04-29 |
| 1306233341 | Healthcare R Us | Home Health | 2859 Sidney St, St Louis, MO 63104 | 2015-04-16 |
| 1396159091 | Daniela Hermelin | Pathology | 1402 South Grane, St. Louis, MO 63104 | 2014-06-20 |
| 1992117881 | Kelly Denise Durbin | Social Worker | 1920 S 7th St, Saint Louis, MO 63104 | 2014-05-27 |
| Find all providers in zip 63104 | ||||
| Taxonomy Code | 2084P0805X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Geriatric Psychiatry |
| Geriatric Psychiatry is a subspecialty with psychiatric expertise in prevention, evaluation, diagnosis and treatment of mental and emotional disorders in the elderly, and improvement of psychiatric care for healthy and ill elderly patients. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770743189 | Vadim Baram Md, Inc. | Psychiatry & Neurology | 10420 Old Olive Street Rd Ste 205, Saint Louis, MO 63141-5937 | 2008-06-10 |
| 1174008452 | Rita Khoury | Psychiatry & Neurology | 1438 S Grand Blvd, Saint Louis, MO 63104-1027 | 2018-10-02 |
| 1942392931 | William M Irvin Jr. | Psychiatry & Neurology | 11477 Olde Cabin Rd Ste 210, Saint Louis, MO 63141-7129 | 2006-09-28 |
| 1093727471 | St. Louis Psychiatry Doctors Group, LLC | Psychiatry & Neurology | 2639 Miami St, Saint Louis, MO 63118-3929 | 2006-08-13 |
| 1316990989 | Pratibha Nagenhalli Gurusiddaiya | Psychiatry & Neurology | 1 Jefferson Barracks Dr, Saint Louis, MO 63125-4181 | 2006-05-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902910615 | Dilip Gogineni | Psychiatry & Neurology | John J.pershing Vamc, 1500 Westwood Blvd, Poplar Bluff, MO 63901 | 2006-08-18 |
| 1013917525 | Andrew Lovy | Psychiatry & Neurology | 303 Weller St, Macon, MO 63552-1942 | 2005-07-26 |
| 1447452149 | Maritza Buenaver | Psychiatry & Neurology | 4801 E Linwood Blvd, 2jpp, Kansas City, MO 64128-2226 | 2007-06-04 |
| 1174587703 | Arturo G Quiason | Psychiatry & Neurology | 17221 E 23rd St S, #206, Independence, MO 64057-1803 | 2006-04-12 |
| City | SAINT LOUIS |
| Zip Code | 63104 |
Please comment or provide details below to improve the information on ST LOUIS UNIVERSITY.
| 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.