FARIS AL-GEBORY MD LLC (NPI# 1891025615) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891025615 |
| Entity Type | Organization |
| Organization Name | FARIS AL-GEBORY MD LLC |
| Practice Address |
1011 Bowles Ave Suite 415 Fenton MO 63026-2395 |
| Mailing Address |
11517 Tivoli Ln Saint Louis MO 63146-3539 |
| Practice Telephone | 6367171700 |
| Mailing Telephone | 6367171700 |
| Enumeration Date | 2009-12-29 |
| Last Update Date | 2009-12-29 |
| Authorized Official Name | DR. FARIS AL-GEBORY (OWNER/PRESIDENT) |
| Authorized Official Telephone | 6367171700 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | 2008032789 | MO | Allopathic & Osteopathic Physicians |
| Street Address |
1011 BOWLES AVE SUITE 415 |
| City | FENTON |
| State | MO |
| Zip Code | 63026-2395 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710979208 | Cesar Fernando Munoz | Internal Medicine | 1011 Bowles Ave, Ste. 300, Fenton, MO 63026-2395 | 2005-08-19 |
| 1083120208 | Tiffany Shanta Harold | Nurse Practitioner | 1011 Bowles Ave, Fenton, MO 63026-2395 | 2017-12-26 |
| 1093250334 | Laura Ann Rogers | Registered Nurse | 1011 Bowles Ave, Ste 220, Fenton, MO 63026-2395 | 2016-12-22 |
| 1124579966 | Ssm Medical Group Inc. | Orthopaedic Surgery | 1011 Bowles Ave, Suite 400, Fenton, MO 63026-2395 | 2016-10-17 |
| 1699158196 | Diane Denise Block | Nurse Practitioner | 1011 Bowles Ave, Suite 300, Fenton, MO 63026-2395 | 2015-07-01 |
| 1992196992 | Tara Joann Knoepp | Physical Therapist | 1011 Bowles Ave, Suite 150, Fenton, MO 63026-2395 | 2015-02-11 |
| 1093129538 | Elizabeth Anne Rancour | Dermatology | 1011 Bowles Ave, Ste 121, Fenton, MO 63026 | 2014-06-12 |
| 1558799742 | Amanda Nicole Meitz | Nurse Practitioner | 1011 Bowles Ave, Suite 205, Fenton, MO 63026-2395 | 2013-10-24 |
| 1013253699 | Lita Lapins | Nurse Practitioner | 1011 Bowles Ave, Suite 300, Fenton, MO 63026 | 2012-12-30 |
| 1043568280 | Denise P Blackburn | Registered Nurse | 1011 Bowles Ave, Suite G10, Fenton, MO 63026-2395 | 2012-08-20 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871000372 | Allison Egler | Audiologist | 1011 Bowles Ave Ste 405, Fenton, MO 63026 | 2018-01-05 |
| 1629508213 | Holly Brooks Munson | Massage Therapist | 220 Copper Mountain Dr, Fenton, MO 63026 | 2017-06-15 |
| 1073978862 | Naomi Sharon | Nurse Practitioner | 1101 Bowles Avenue, Suite G50, Fenton, MO 63026 | 2015-12-21 |
| 1871981704 | Celtic Private Care of Il & Mo, LLC | In Home Supportive Care | 1653 Larkin Williams Road, Suite 201, Fenton, MO 63026 | 2014-12-30 |
| 1356747513 | Kristina Potts | Nurse Practitioner | 774 Gravois Bluffs Blvd Ste B, Fenton, MO 63026 | 2014-11-14 |
| 1245642420 | Physicians Health Group Medical Inc | General Practice | 960 S. Highway Dr, Fenton, MO 63026 | 2014-05-22 |
| 1598047409 | Kevin Eugene Bruce | Pharmacist | 1210 Sugar Creek, Fenton, MO 63026 | 2011-09-16 |
| 1215186382 | Concentra Health Services, Inc. | Clinic/Center | 128 Matrix Commons Dr., Fenton, MO 63026 | 2008-09-15 |
| 1790954410 | Castlewood Treatment Center LLC | Community/Behavioral Health | 1855 Bowles Ave, Suite 210, Fenton, MO 63026 | 2008-02-27 |
| 1073703617 | Christina R Baeres | Dietitian, Registered | 38 Majestic Ct, Fenton, MO 63026 | 2007-07-30 |
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| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| 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 Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417940412 | Enrique Pastrana | Surgery | 1011 Bowles Ave., Suite 300, Fenton, MO 63026-2387 | 2005-08-24 |
| 1457791808 | Patricia Heller | Surgery | 1011 Bowles Ave Ste 425, Fenton, MO 63026-2384 | 2013-06-30 |
| 1326485897 | Aaron Bornstein | Surgery | 1011 Bowles Ave Ste 300, Fenton, MO 63026-2387 | 2013-05-23 |
| 1841419827 | Enrique Pastrana, M.d., P.c | Surgery | 1011 Bowles Ave., Suite 300, Fenton, MO 63026-2387 | 2007-04-25 |
| 1871617993 | Allison K Davis | Surgery | 1011 Bowles Avenue, Suite 425, Fenton, MO 63026 | 2007-03-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134623317 | Kuirong Jiang | Surgery | 1 Hospital Dr Rm Mc520, Columbia, MO 65212-1000 | 2018-03-21 |
| 1962926311 | Blaire Lori Anderson | Surgery | 4921 Parkview Place Ste 8c, St Louis, MO 63110 | 2017-07-27 |
| 1578084349 | Shoaib Safiullah | Surgery | 1 Hospital Dr # Dc075.00, Columbia, MO 65212-1000 | 2017-07-03 |
| 1003336934 | Bradley Kushner | Surgery | 660 S Euclid Ave Fl 9, Saint Louis, MO 63110-1010 | 2017-06-21 |
| 1982088571 | Maxwell Tanyi Fohtung | Surgery | 4949 W Pine Blvd, Saint Louis, MO 63108 | 2015-07-14 |
| 1376920538 | Jordan M Kirsch | Surgery | 660 S. Euclid Ave, Cb 8109, Saint Louis, MO 63110-1020 | 2015-04-27 |
| 1194117861 | Kaitlyn Marie Rountree | Surgery | 1 Hospital Dr # Mc404, Columbia, MO 65212-1000 | 2015-03-04 |
| 1003231002 | Mysorekar Surgical | Surgery | 8342 Delcrest Dr, Apt 303, Saint Louis, MO 63124-2100 | 2014-02-27 |
| 1588099725 | Francis Milton Corry | Surgery | 2859 E. Utica, Springfield, MO 65804 | 2013-09-06 |
| 1710327879 | Jason Matthew Loden | Surgery | 1333 S Sam Houston Blvd Ste C, Houston, MO 65483-2046 | 2013-07-03 |
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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.