DR. ROBERT J BACKER (NPI# 1790788941) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790788941 |
| Entity Type | Individual |
| Full Name | DR. ROBERT J BACKER |
| Credential | MD |
| Practice Address |
621 S New Ballas Rd Ste 297a Saint Louis MO 63141-8232 |
| Practice Telephone | 3142516364 |
| Practice Fax Number | 3142517897 |
| Mailing Telephone | 3142516364 |
| Mailing Fax Number | 3142517897 |
| Enumeration Date | 2005-05-23 |
| Last Update Date | 2011-02-10 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | MDR3D60 | MO | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | UNITED HEALTHCARE | 0600013 | 01 |
| MO | BLUE CROSS BLUE SHIELD | 5810 | 01 |
| MO | MEDICARE RAILROAD | 140005147 | 01 |
| MO | GROUP HEALTH PLAN | 43755 | 01 |
| MO | TAX ID # | 431725782 | 01 |
| MO | HEALTHLINK | 132437 | 01 |
| TAX ID | 261839808 | 01 | |
| MO | EXCLUSIVE CHOICE | O06214 | 01 |
| Street Address |
621 S NEW BALLAS RD STE 297A |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63141-8232 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609362474 | Manesh Kumar Gangwani | Internal Medicine | 621 S New Ballas Rd, Saint Louis, MO 63141-8232 | 2018-07-05 |
| 1164918165 | Ayesha Farrukh | Internal Medicine | 621 S New Ballas Rd, Saint Louis, MO 63141-8232 | 2018-07-03 |
| 1720573769 | Chelsea Renee Drissell | Family Medicine | 621 S New Ballas Rd, Saint Louis, MO 63141 | 2018-06-22 |
| 1023502358 | Bryan Gabriel Acree | Internal Medicine | 621 S New Ballas Rd, Saint Louis, MO 63141-8232 | 2018-06-20 |
| 1700370996 | Kathryn Emily Harvey-feldewerth | Internal Medicine | 621 S New Ballas Rd, Saint Louis, MO 63141-8232 | 2018-06-20 |
| 1063906493 | Paul Pearson Panasiuk | Obstetrics & Gynecology | 621 S New Ballas Rd, Saint Louis, MO 63141-8232 | 2018-06-19 |
| 1558855056 | Jessica Jenkins | Obstetrics & Gynecology | 621 S New Ballas Rd, Saint Louis, MO 63141-8232 | 2018-06-18 |
| 1679067276 | Kristopher Vaughn Pullam | Family Medicine | 621 S New Ballas Rd, Saint Louis, MO 63141-8232 | 2018-06-18 |
| 1932693629 | Lawrence Andrew Rudolf | Family Medicine | 621 S New Ballas Rd, Saint Louis, MO 63141-8232 | 2018-06-18 |
| 1467946160 | Lauren Elizabeth Buchanan | Obstetrics & Gynecology | 621 S New Ballas Rd, Saint Louis, MO 63141-8232 | 2018-06-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679102842 | Noor Ramadan | Pharmacist | 628 North New Ballad Road, Suite A, Creve Coeur, MO 63141 | 2020-04-08 |
| 1497381206 | Washington University | Durable Medical Equipment & Medical Supplies | 1044 North Mason Road, Suite 110/210, St. Louis, MO 63141 | 2020-03-13 |
| 1154956498 | Ashleigh Clendenny | Physician Assistant | Mercy Hospital St. Louis, 615 S New Ballas Rd, St. Louis, MO 63141 | 2020-03-06 |
| 1801429410 | Emili Lou Haley | Registered Nurse | 650 Maryville Drive, St Louis, MO 63141 | 2020-02-21 |
| 1629553110 | Rebecca Kathleen Pike | Social Worker | West County Psychological Associates, 12125 Woodcrest Executive Drive #110, St. Louis, MO 63141 | 2018-10-01 |
| 1649756099 | River City Sedation Associates, LLC | Nurse Anesthetist, Certified Registered | 12855 N 40 Dr Ste 150, Saint Louis, MO 63141 | 2018-07-18 |
| 1205333952 | Ear Care and Hearing of St. Louis | Hearing Aid Equipment | 11630 Studt Ave Ste 210, Creve Coeur, MO 63141 | 2018-04-10 |
| 1659897486 | Erin Goodman | Physical Therapist | 10560 Old Olive St. Rd, Suite 100, Creve Coeur, MO 63141 | 2017-08-14 |
| 1093230450 | Center for Urologic Surgery LLC | Clinic/Center | 12855 N 40 Dr Ste 100, Saint Louis, MO 63141 | 2017-08-07 |
| 1871016105 | Jacob Farley Tanner | Specialist/Technologist | 1054 Town and Four Parkway Dr, Creve Coeur, MO 63141 | 2017-07-19 |
| Find all providers in zip 63141 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497381990 | Styles 40 Salon | Specialist | 4550 Gravois Ave, Saint Louis, MO 63116-2426 | 2020-03-16 |
| 1013560721 | Against The Grainz | Specialist | 8523 Drury Ln, Saint Louis, MO 63147-1313 | 2019-07-22 |
| 1487211033 | Kia Lanay Lewis | Specialist | 9700 Portage Dr, Saint Louis, MO 63136-5312 | 2019-05-20 |
| 1376011007 | Lashonda S Wash | Specialist | 222 Bruce Ave, Saint Louis, MO 63135-2704 | 2018-11-12 |
| 1326516048 | Showna Walker | Specialist | 2242 Berwyn Dr, Saint Louis, MO 63136-5415 | 2018-11-12 |
| 1760973697 | Angela Haas | Specialist | 1361 Childress Ave, Saint Louis, MO 63139-3451 | 2018-05-26 |
| 1962907782 | Kelsey Conley | Specialist | 2839 Howard St, Saint Louis, MO 63106-2027 | 2018-03-25 |
| 1285135848 | Che Salon | Specialist | 8416 Olive Blvd, Saint Louis, MO 63132-2816 | 2018-02-27 |
| 1790225084 | Michael Bergman | Specialist | 6327 S Grand Blvd, Apt 1g, Saint Louis, MO 63111-2653 | 2017-03-06 |
| 1275082406 | Tim Fick | Specialist | 5157 Lemay Ferry Rd, Saint Louis, MO 63129-1533 | 2016-09-29 |
| Find all providers in SAINT LOUIS | ||||
| City | SAINT LOUIS |
| Zip Code | 63141 |
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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.