GREAT PLAINS RADIOLOGY LLC (NPI# 1780707877) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780707877 |
| Entity Type | Organization |
| Organization Name | GREAT PLAINS RADIOLOGY LLC |
| Practice Address |
12639 Old Tesson Rd Suite 115 Saint Louis MO 63128-2786 |
| Mailing Address |
125 E Clinton Pl Apt 2a Kirkwood MO 63122-6172 |
| Practice Telephone | 3148428655 |
| Practice Fax Number | 3148422972 |
| Mailing Telephone | 3148220690 |
| Mailing Fax Number | 3148422972 |
| Enumeration Date | 2007-04-06 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. EDWARD RENE HABERT (DIRECTOR) |
| Authorized Official Telephone | 3148220690 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians |
| Street Address |
12639 OLD TESSON RD SUITE 115 |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63128-2786 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831191014 | Jeremy D Dunbarr | Physician Assistant | 12639 Old Tesson Rd, Suite 115, Saint Louis, MO 63128-2786 | 2005-06-01 |
| 1558978403 | Christopher Scott Thaller | Physical Therapist | 12639 Old Tesson Rd, Saint Louis, MO 63128-2711 | 2020-09-24 |
| 1225652514 | Erica Nicole Reeg | Nurse Practitioner | 12639 Old Tesson Rd, Saint Louis, MO 63128-2711 | 2020-06-02 |
| 1356615538 | Shayna Leigh Laramore | Nurse Practitioner | 12639 Old Tesson Rd, Suite, Saint Louis, MO 63128-2786 | 2012-03-06 |
| 1467729988 | Signature Medical Grou P of Kc, P.a. | Durable Medical Equipment & Medical Supplies | 12639 Old Tesson Rd, Suite 115, Saint Louis, MO 63128-2786 | 2011-11-29 |
| 1477876415 | Meghan C Flynn | Physician Assistant | 12639 Old Tesson Rd, Suite 115, Saint Louis, MO 63128-2786 | 2010-03-04 |
| 1376789362 | Dana Kay Mcquade | Physical Therapy Assistant | 12639 Old Tesson Rd, Suite 120, Saint Louis, MO 63128-2786 | 2008-12-23 |
| 1114171535 | Medical Implant Sloutions, LLC | Durable Medical Equipment & Medical Supplies | 12639 Old Tesson Rd, 116, Saint Louis, MO 63128-2786 | 2008-11-12 |
| 1154572170 | Signature Healthcare Foundation | Durable Medical Equipment & Medical Supplies | 12639 Old Tesson Rd, Suite 120, Saint Louis, MO 63128-2786 | 2008-10-08 |
| 1396991436 | Meghan D Sinon | Physician Assistant | 12639 Old Tesson Rd, Suite 115, Saint Louis, MO 63128-2786 | 2008-08-08 |
| Find all providers in the same location | ||||
| 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 | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| 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 Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609130566 | Kristin Harris Drake | Radiology | 621 S New Ballas Rd Ste 23a, Saint Louis, MO 63141 | 2012-06-26 |
| 1093083016 | William G Crawford | Radiology | 61 Crestwood Dr, Saint Louis, MO 63105-3020 | 2011-12-05 |
| 1558657643 | Joseph Gary Livingston | Radiology | One Barnes-jewsih Hospital Plaza, Mailstop 90-09-355, Saint Louis, MO 63110 | 2011-06-27 |
| 1013219344 | Pure Imaging LLC | Radiology | 12345 West Bend Drive, Saint Louis, MO 63128-2104 | 2010-11-18 |
| 1881884658 | Zhengming Gu | Radiology | 9240 Radiom Dr, Saint Louis, MO 63123-5545 | 2007-07-27 |
| 1306057310 | Mohammed Ali Abbas | Radiology | 1402 S Grand Blvd Rm 260, Saint Louis, MO 63104-1004 | 2007-05-24 |
| 1104040963 | Saadoon Kadir | Radiology | 2909 Netherton Dr, Saint Louis, MO 63136-4677 | 2007-04-12 |
| 1376612739 | Carl Joseph Aschkenasi | Radiology | 898 Alanson Dr, Saint Louis, MO 63132-5039 | 2006-11-07 |
| 1629182829 | Jeffery A Hardy | Radiology | 2344 Hampton Ave, Saint Louis, MO 63139-2909 | 2006-08-18 |
| 1124132436 | Alfred D Shaplin | Radiology | 1034 S Brentwood Blvd Ste 280, Saint Louis, MO 63117-1221 | 2006-08-17 |
| 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.