ST LOUIS UNIVERSITY (NPI# 1740253095) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740253095 |
| Entity Type | Organization |
| Organization Name | ST LOUIS UNIVERSITY |
| Other Organization Name | SLUCARE DEPARTMENT OF DERMATOLOGY |
| Practice Address |
1755 S Grand Blvd Saint Louis MO 63104-1540 |
| Mailing Address |
1831 Chestnut St Ste 650 Saint Louis MO 63103-2236 |
| Practice Telephone | 3149776828 |
| Practice Fax Number | 3142563431 |
| Mailing Telephone | 3149776828 |
| Enumeration Date | 2006-02-08 |
| Last Update Date | 2019-06-20 |
| Authorized Official Name | MRS. ALYCE LANXON (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 3149776828 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| SLUCare Department of Dermatology | 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 |
| 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 |
| 1912281718 | St Louis University | Internal Medicine | 3660 Vista Ave, Saint Louis, MO 63110-2540 | 2011-09-29 |
| Street Address |
1755 S GRAND BLVD |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63104-1540 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295363372 | Jordan Benjamin Leynes | Physician Assistant | 1755 S Grand Blvd, Saint Louis, MO 63104-1540 | 2020-04-01 |
| 1366936411 | Gabriela Madeleine Morris | Internal Medicine | 1755 S Grand Blvd, Saint Louis, MO 63104 | 2018-06-20 |
| 1891228425 | Madelyn Farrell Oliver Jeter | Student in an Organized Health Care Education/Training Program | 1755 S Grand Blvd, Saint Louis, MO 63104-1540 | 2017-04-10 |
| 1982079810 | Claudia Sophia Morr Verenzuela | Dermatology | 1755 S Grand Blvd, Saint Louis, MO 63104-1540 | 2015-12-03 |
| 1528447125 | Kristin Colleen Smith | Dermatology | 1755 S Grand Blvd, Saint Louis, MO 63104-1540 | 2015-05-28 |
| 1205213253 | Ashley Mcwilliams | Student in an Organized Health Care Education/Training Program | 1755 S Grand Blvd, Saint Louis, MO 63104-1540 | 2015-04-29 |
| 1154714202 | Heidi Elaine Roeder | Physician Assistant | 1755 S Grand Blvd, Saint Louis, MO 63104-1540 | 2015-03-13 |
| 1134534811 | Jennifer Albus Fehlman | Dermatology | 1755 S Grand Blvd, Saint Louis, MO 63104-1540 | 2014-06-21 |
| 1124446588 | Saniya Shaikh | Student in an Organized Health Care Education/Training Program | 1755 S Grand Blvd, Saint Louis, MO 63104-1540 | 2014-04-02 |
| 1710326467 | Megan Alexis Walters | Orthopaedic Surgery | 1755 S Grand Blvd, Saint Louis, MO 63104 | 2013-06-17 |
| 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 | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922605906 | Deluxe Dermatology LLC | Dermatology | 1034 S Brentwood Blvd Ste 1000, Saint Louis, MO 63117-1210 | 2020-10-03 |
| 1417597923 | Anna Marie Aiazzi | Dermatology | 10012 Kennerly Rd Ste 401, Saint Louis, MO 63128-2197 | 2020-01-13 |
| 1821482373 | David Cotter | Dermatology | 9450 Minerva Ave, Saint Louis, MO 63114-3910 | 2015-03-23 |
| 1710320767 | Mallory Shiver Abate | Dermatology | 1755 S Grand Blvd Dept of Dermatology, Saint Louis, MO 63104-1540 | 2013-04-09 |
| 1689935728 | Rebecca Joy Chibnall | Dermatology | 5225 Mid America Plz Ste 2300, Ste 2300, Saint Louis, MO 63129-0002 | 2012-06-05 |
| 1285928697 | Urvi Patel | Dermatology | 522 N New Ballas Rd Ste 316, Ste 316, Saint Louis, MO 63141-6840 | 2011-06-02 |
| 1235428582 | Hala Fatima Adil | Dermatology | 2315 Dougherty Ferry Rd Ste 200b, Slucare Dermatology, Saint Louis, MO 63122-3383 | 2011-04-06 |
| 1376852087 | Michael Slade Stratton | Dermatology | 2325 Dougherty Ferry Rd Ste 201, Saint Louis, MO 63122-3356 | 2010-09-29 |
| 1255643813 | Sarah Alison Finger Basak | Dermatology | 12855 N 40 Dr Ste 180, Saint Louis, MO 63141-8657 | 2010-07-11 |
| 1285835454 | Nita Kohli | Dermatology | 4901 Forest Park Ave Ste 502, Ste 502, Saint Louis, MO 63108-1402 | 2007-05-29 |
| Find all providers in SAINT LOUIS | ||||
| City | SAINT LOUIS |
| Zip Code | 63104 |
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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.