DR. MARTIN GRISSOM (NPI# 1831117449) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831117449 |
| Entity Type | Individual |
| Full Name | DR. MARTIN GRISSOM |
| Credential | MD, MS, FCCP |
| Practice Address |
2330 Time Centre Dr Saint Charles MO 63303-2112 |
| Mailing Address |
Po Box 1889 Saint Charles MO 63302-1889 |
| Practice Telephone | 6364935103 |
| Practice Fax Number | 6362727385 |
| Mailing Telephone | 6364935103 |
| Mailing Fax Number | 6362727385 |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2015-02-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207LC0200X |
Anesthesiology Specialization: Critical Care Medicine |
01058266A | IN | Allopathic & Osteopathic Physicians |
| Y | 207LC0200X |
Anesthesiology Specialization: Critical Care Medicine |
35-06-5824-G | OH | Allopathic & Osteopathic Physicians |
| N | 207RC0200X |
Internal Medicine Specialization: Critical Care Medicine |
2006038287 | MO | Allopathic & Osteopathic Physicians |
| N | 208M00000X | Hospitalist | 01058266A | IN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 204581805 | 05 |
| Street Address |
2330 TIME CENTRE DR |
| City | SAINT CHARLES |
| State | MO |
| Zip Code | 63303-2112 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083214787 | Michael Frederick | Pharmacist | 2855 Veterans Memorial Parkway, (pharmacy), Saint Charles, MO 63303 | 2020-10-30 |
| 1710525639 | Cheryl Ann O'dell | Pharmacist | Schnucks Pharmacy, 60 Harvester Square, St Charles, MO 63303 | 2019-12-11 |
| 1255821302 | Melinda R Winfield | Nurse Practitioner | 1313 Park Ct, Saint Charles, MO 63303 | 2018-05-15 |
| 1467904839 | Heather Lilledahl | Speech-Language Pathologist | 2800 Old Muegge Road, Saint Charles, MO 63303 | 2016-11-01 |
| 1437608312 | Preferred Family Healthcare | Counselor | 1559 Old S. River Road, St.charles, MO 63303 | 2016-10-03 |
| 1487109146 | Annette Patricia Davenport | Nurse Practitioner | 1551 Wall Street, Logistics Health Inc, Suite 100, Saint Charles, MO 63303 | 2016-08-23 |
| 1053762328 | Sarah Biondo | Speech-Language Pathologist | 7204 Fountainview Circle, Ofallon, MO 63303 | 2016-06-28 |
| 1710331335 | Lindsey Ann Eilers | Counselor | 1570 South Main, Saint Charles, MO 63303 | 2016-04-20 |
| 1174914600 | Jacquelyn Michele Miller | Pharmacy Technician | 3881 Mexico Road, Saint Charles, MO 63303 | 2015-02-05 |
| 1164838132 | Francelle Denise Neal | Counselor | 2480 Executive Dr Ste 111, Saint Charles, MO 63303 | 2014-07-10 |
| Find all providers in zip 63303 | ||||
| Taxonomy Code | 207LC0200X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Anesthesiology |
| Specialization | Critical Care Medicine |
| An anesthesiologist, who specializes in critical care medicine diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Anesthesiology, 2007. http://www.theaba.org/; American Osteopathic Board of Anesthesiology, 2007, http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Anesthesiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Anesthesiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538286984 | Robert William Reid | Anesthesiology | 800 Nw Chipman Rd, Ste 5950, Lees Summit, MO 64063-1873 | 2007-03-23 |
| 1265525133 | Anesthesia Services of Blue Springs | Anesthesiology | 4150 N Mulberry Dr Ste 100, Anesthesia Services Blue Springs/briarcliff Surgery Ctr, Kansas City, MO 64116-1779 | 2006-10-02 |
| 1619590288 | Pratik Sinha | Anesthesiology | 1 Barnes Jewish Hospital Plz, Dept Anesthesiology, Saint Louis, MO 63110-1003 | 2020-05-18 |
| 1093240483 | Aaron Thomas Surrey | Anesthesiology | 1 Barnes Jewish Hospital Plz, Saint Louis, MO 63110-1003 | 2017-04-24 |
| 1366975922 | Jelaina Scott | Anesthesiology | 1 Barnes Jewish Hospital Plz, Saint Louis, MO 63110-1003 | 2017-04-10 |
| 1316308729 | Michael Wojdan | Anesthesiology | 1 Barnes Jewish Hospital Plz, Saint Louis, MO 63110-1003 | 2016-03-11 |
| 1881018919 | Lynn Pauls | Anesthesiology | 1 Barnes Jewish Hospital Plz, Saint Louis, MO 63110-1003 | 2014-02-10 |
| 1366881427 | Cody Jamison Barnes | Anesthesiology | 4901 Forest Park Ave, Ste 420, Saint Louis, MO 63108-1495 | 2013-06-21 |
| 1508209313 | Amjad Musleh | Anesthesiology | 1 Barnes Jewish Hospital Plz, Saint Louis, MO 63110-1003 | 2013-04-10 |
| 1447592522 | Anton Travis Manasco | Anesthesiology | 1 Barnes Jewish Hospital Plz, Saint Louis, MO 63110-1003 | 2013-03-26 |
| Find all providers with the same taxonomy | ||||
| City | SAINT CHARLES |
| Zip Code | 63303 |
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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.