DR. POONAM M JAIN (NPI# 1851446207) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851446207 |
| Entity Type | Individual |
| Full Name | DR. POONAM M JAIN |
| Other Name | POONAM M MANGAL |
| Credential | M.D. |
| Practice Address |
1 Meadow Acres Saint Louis MO 63124-1460 |
| Mailing Address |
Po Box 31637 Saint Louis MO 63131-0637 |
| Practice Telephone | 3143086965 |
| Mailing Telephone | 3143086965 |
| Mailing Fax Number | 3148018700 |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2016-01-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RG0300X |
Internal Medicine Specialization: Geriatric Medicine |
102417 | MO | Allopathic & Osteopathic Physicians |
| N | 207RH0002X |
Internal Medicine Specialization: Hospice and Palliative Medicine |
102417 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 206644031 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790799385 | Poonam Jain | Dentist | 24 Ginger Creek Pkwy, Glen Carbon, IL 62034-3502 | 2006-07-28 |
| Street Address |
1 MEADOW ACRES |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63124-1460 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740481258 | Long Term Consultants LLC | Internal Medicine | 1 Meadow Acres, Saint Louis, MO 63124-1460 | 2007-05-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174174775 | Nicholas Simpson | Nurse Practitioner | 8857 Ladue Road, St. Louis, MO 63124 | 2019-09-25 |
| 1144774647 | Carolyn Ashley Myles Versical | Psychologist | 26 Godwin Ln, Saint Louis, MO 63124 | 2016-08-12 |
| 1740669373 | Victor's Home Care Cds, LLC | Hospice Care, Community Based | 8420 Delmar Blvd, Ste 507, St. Louis, MO 63124 | 2015-05-28 |
| 1851784490 | Bryan Watanabe Dds Ladue Dental Group, PC | Dentist | 8859 Ladue Road, Ladue, MO 63124 | 2015-03-06 |
| 1689072324 | Ladue Internal Medicine, LLC | Internal Medicine | 8857 A Ladue Rd., Ladue, MO 63124 | 2014-12-11 |
| 1043557150 | Ronald Nathan Riner | Internal Medicine | 9847 Waterbury Drive, St. Louis, MO 63124 | 2013-01-09 |
| 1295099638 | David Stuart Sonderman | Pediatrics | 8888 Ladue Road, Ste 100, Saint Louis, MO 63124 | 2012-06-29 |
| 1255637799 | Kyu S Her | Pediatrics | 624 Haverford Road, St. Louis, MO 63124 | 2011-02-01 |
| 1194983833 | Roberte Kuhlman | Orthopaedic Surgery | 12 Upper Barnes, St Louis, MO 63124 | 2008-05-29 |
| 1467507673 | Mark William Aylward | Dentist | 9216 Clayton Road, Suite 118, St Louis, MO 63124 | 2007-01-25 |
| Find all providers in zip 63124 | ||||
| Taxonomy Code | 207RG0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Geriatric Medicine |
| An internist who has special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes and the hospital. |
| 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 Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023592946 | Institute of Medicine LLC | Internal Medicine | 6824 Balson Ave, Saint Louis, MO 63143-2603 | 2018-09-17 |
| 1104235241 | Generation Clinical Partners LLC | Internal Medicine | 11500 Olive Blvd Ste 235, Saint Louis, MO 63141-7141 | 2014-08-02 |
| 1558563890 | Hassan Dawoud Elsiddig | Internal Medicine | 3660 Vista Ave # 204, Saint Louis, MO 63110-2540 | 2007-05-31 |
| 1871795104 | Shehla Sadiq | Internal Medicine | 3660 Vista Ave # 2104, Saint Louis, MO 63110-2540 | 2007-05-31 |
| 1184755118 | Geromed, LLC | Internal Medicine | 4675 S Grand Blvd, Saint Louis, MO 63111-1462 | 2007-03-09 |
| 1154484673 | Miriam B Rodin | Internal Medicine | 1402 S Grand Blvd Rm 238, Division of Geriatric Medicine, Saint Louis, MO 63104-1004 | 2006-12-18 |
| 1992815906 | Susan Robinson Reeds | Internal Medicine | 8 Millstone Campus Dr, Ste 1500, Saint Louis, MO 63146-5766 | 2006-08-30 |
| 1780602417 | Monique Marie Williams | Internal Medicine | 969 N Mason Rd Ste 145, Saint Louis, MO 63141 | 2006-07-18 |
| 1124073630 | Rafi Thomas Kevorkian | Internal Medicine | 522 N New Ballas Rd Ste 317, Saint Louis, MO 63141-6840 | 2006-05-23 |
| 1902881279 | Wit Anthony Jamry | Internal Medicine | 5621 Delmar Blvd, #105, Saint Louis, MO 63112-2656 | 2005-12-09 |
| Find all providers in SAINT LOUIS | ||||
| City | SAINT LOUIS |
| Zip Code | 63124 |
Please comment or provide details below to improve the information on DR. POONAM M JAIN.
| 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.