DR. STEPHEN ROBERT BRODERICK (NPI# 1699934828) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699934828 |
| Entity Type | Individual |
| Full Name | DR. STEPHEN ROBERT BRODERICK |
| Credential | MD |
| Practice Address |
222 S Woods Mill Rd 550n Chesterfield MO 63017-3625 |
| Practice Telephone | 3144343049 |
| Practice Fax Number | 3142056916 |
| Mailing Telephone | 3144343049 |
| Mailing Fax Number | 3142056916 |
| Enumeration Date | 2008-06-03 |
| Last Update Date | 2015-12-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208600000X | Surgery | 2012013459 | MO | Allopathic & Osteopathic Physicians |
| Y | 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 2012013459 | MO | Allopathic & Osteopathic Physicians |
| Street Address |
222 S WOODS MILL RD 550N |
| City | CHESTERFIELD |
| State | MO |
| Zip Code | 63017-3625 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396744835 | Cordie C Coordes | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 222 S Woods Mill Rd, Suite 550-n, Chesterfield, MO 63017-3625 | 2005-07-18 |
| 1629681358 | Reihaneh Chokhachi Zadeh Moghadam | Internal Medicine | 222 S Woods Mill Rd, Chesterfield, MO 63017-3625 | 2020-08-24 |
| 1770193054 | Imad Karam | Internal Medicine | 222 S Woods Mill Rd, Chesterfield, MO 63017-3625 | 2020-08-03 |
| 1932718210 | Manuel Fernando Sanchez | Internal Medicine | 222 S Woods Mill Rd, Chesterfield, MO 63017-3625 | 2020-07-23 |
| 1942828967 | Felina Innaci Dass | Internal Medicine | 222 S Woods Mill Rd, Chesterfield, MO 63017-3625 | 2020-07-07 |
| 1356968069 | Justin Michael Barnes | Internal Medicine | 222 S Woods Mill Rd, Chesterfield, MO 63017-3625 | 2020-06-29 |
| 1063039774 | Zoe Leyh | Internal Medicine | 222 S Woods Mill Rd, Chesterfield, MO 63017-3625 | 2020-06-29 |
| 1770100497 | Ishaan Jakhar | Internal Medicine | 222 S Woods Mill Rd, Chesterfield, MO 63017-3625 | 2020-06-29 |
| 1376169433 | Kyle Branson | Internal Medicine | 222 S Woods Mill Rd, Chesterfield, MO 63017-3625 | 2020-06-24 |
| 1619593779 | Ayooluwatomiwa Deborah Adekunle | Internal Medicine | 222 S Woods Mill Rd, Chesterfield, MO 63017-3625 | 2020-06-24 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114549193 | Kathryn E Bos | Student in an Organized Health Care Education/Training Program | 873 Apt N Foxsprings Dr, Chesterfield, MO 63017 | 2020-05-12 |
| 1700415171 | Charles H. Edwards | Physical Therapist | 224 South Woods Millrd., Suite 610 South, Chesterfield, MO 63017 | 2020-04-07 |
| 1003454562 | Stephanie Henningsen | Physical Therapy Assistant | 307 S Woods Rd, Chesterfield, MO 63017 | 2019-12-16 |
| 1831746296 | Star Lynn Sutton | Occupational Therapy Assistant | 15207 Olive Boulevard, Chesterfield, MO 63017 | 2019-08-21 |
| 1639738438 | Van Amburg & Busiek Md's, LLC | Pharmacy | 232 S Woodsmill Road, Suite 330 East, Chesterfield, MO 63017 | 2019-06-06 |
| 1306306865 | Margaret Mary Wynn | Nurse Practitioner | 15740 South Outer Road, Chesterfield, MO 63017 | 2019-03-21 |
| 1205393089 | Kimberly Danielle | Nurse Practitioner | 744 Forest Trace Dr, Chesterfield, MO 63017 | 2019-02-27 |
| 1457823965 | Allison Joy Mcgrail | Dietitian, Registered | 45740 S Outer Forty Rd, Chesterfield, MO 63017 | 2018-12-21 |
| 1316418080 | Julie Lefere | Social Worker | Mercy Virtual Care Center, 15740 S Outer 40 Rd, Chesterfield, MO 63017 | 2018-12-06 |
| 1336629641 | Catherine Dolphin Smith | Nurse Practitioner | 224 S Woods Mill Rd Ste 500, Chesterfield, MO 63017 | 2018-08-16 |
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| Taxonomy Code | 208G00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Thoracic Surgery (Cardiothoracic Vascular Surgery) |
| A thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the surgical care of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the trachea, abnormalities of the great vessels and heart valves, congenital anomalies, tumors of the mediastinum and diseases of the diaphragm. The management of the airway and injuries of the chest is within the scope of the specialty. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Thoracic Surgery, 2007. http://www.abts.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Thoracic Surgery. Thoracic surgeons have the knowledge, experience and technical skills to accurately diagnose, operate upon safely, and effectively manage patients with thoracic diseases of the chest. This requires substantial knowledge of cardiorespiratory physiology and oncology, as well as capability in the use of heart assist devices, management of abnormal heart rhythms and drainage of the chest cavity, respiratory support systems, endoscopy and invasive and noninvasive diagnostic techniques. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396744835 | Cordie C Coordes | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 222 S Woods Mill Rd, Suite 550-n, Chesterfield, MO 63017-3625 | 2005-07-18 |
| 1447575964 | Michael Ryan Reidy | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 222 S Woods Mill Rd Ste 550n, Chesterfield, MO 63017-3641 | 2010-03-29 |
| 1912937384 | Victor H Ruiz | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 224 S Woods Mill Rd, Suite 450s, Chesterfield, MO 63017-3451 | 2006-07-03 |
| 1104895812 | Cardiothoracic Surgery, LLC | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 222 S Woods Mill Rd, Suite 550-n, Chesterfield, MO 63017-3625 | 2006-03-15 |
| 1770582223 | Joseph G Lugo | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 222 S Woods Mill Rd, Suite 550-n, Chesterfield, MO 63017-3625 | 2005-07-18 |
| 1215936745 | Ronald D Leidenfrost | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 222 S Woods Mill Rd, Suite 550-n, Chesterfield, MO 63017-3625 | 2005-07-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891034484 | John Phillip Connors | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1733 Kenmont Rd, Saint Louis, MO 63124-1021 | 2013-02-03 |
| 1699074336 | Joseph John Platz | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1035 Belleville Aveune, Suite 500, St. Louis, MO 63117 | 2011-03-21 |
| 1114243995 | Graham Robertson Young Pollock | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 4320 Wornall Rd Ste 50-ii, Kansas City, MO 64111-5941 | 2010-04-19 |
| 1639305055 | George C Kaiser | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 30 Joy Ave, Webster Groves, MO 63119-2502 | 2009-06-01 |
| 1043460710 | Justin Van Meeteren | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 2330 E Meyer Blvd Ste 505, Kansas City, MO 64132-1152 | 2008-09-30 |
| 1508024753 | Tracy Elmer Strevey Jr. | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1509 Woodgate Dr, Frontenac, MO 63131-4724 | 2008-05-23 |
| 1275712010 | Donovan Mitchell Stinnett | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1701 W 26th St, Suite B, Joplin, MO 64804-1513 | 2007-10-29 |
| 1720277197 | Heart and Vascular Care | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 412 Highway 71, Suite J, Pineville, MO 64856-9310 | 2007-10-22 |
| 1801008396 | Peter Fonseca Md, PC | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 10004 Kennerly, Suite 345a, St. Louis, MO 63128 | 2007-05-04 |
| 1669531182 | James N. Pinckley | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1900 S. National, Suite 3400, Springfield, MO 65804 | 2006-12-08 |
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| City | CHESTERFIELD |
| Zip Code | 63017 |
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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.