MERCY CLINIC ST. LOUIS CANCER AND BREAST INSTITUTE, LLC (NPI# 1891946349) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891946349 |
| Entity Type | Organization |
| Organization Name | MERCY CLINIC ST. LOUIS CANCER AND BREAST INSTITUTE, LLC |
| Other Organization Name | ST LOUIS CANCER AND BREAST INSTITUTE |
| Practice Address |
621 S New Ballas Rd Ste 260a Saint Louis MO 63141-8256 |
| Mailing Address |
15945 Clayton Rd Suite 120 Ballwin MO 63011-2490 |
| Practice Telephone | 3142518001 |
| Practice Fax Number | 3142565043 |
| Mailing Telephone | 6362565000 |
| Mailing Fax Number | 3149891323 |
| Enumeration Date | 2008-10-02 |
| Last Update Date | 2018-11-19 |
| Authorized Official Name | JOHN W. HUBERT (PRESIDENT) |
| Authorized Official Telephone | 3142511700 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | Y |
| Parent Organization Name | MERCY CLINIC EAST COMMUNITIES |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RH0000X |
Internal Medicine Specialization: Hematology |
Allopathic & Osteopathic Physicians | ||
| N | 207RX0202X |
Internal Medicine Specialization: Medical Oncology |
Allopathic & Osteopathic Physicians | ||
| N | 2085R0001X |
Radiology Specialization: Radiation Oncology |
Allopathic & Osteopathic Physicians | ||
| Y | 2086X0206X |
Surgery Specialization: Surgical Oncology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 504721903 | 05 |
| Other Name | Type Code |
|---|---|
| ST LOUIS CANCER AND BREAST INSTITUTE | Former Legal Business Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 15945 Clayton Rd, Suite 120, Ballwin, MO 630112490 | 6362565000 | 3149891323 |
| Street Address |
621 S NEW BALLAS RD STE 260A |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63141-8256 |
| 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 | 2086X0206X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Surgical Oncology |
| A surgical oncologist is a well-qualified surgeon who has obtained additional training and experience in the multidisciplinary approach to the prevention, diagnosis, treatment, and rehabilitation of cancer patients, and devotes a major portion of his or her professional practice to these activities and cancer research. |
| Notes: Source: Society of Surgical Oncology, 2007 [1/1/2008: definition added, source added, 7/1/2009: definiition reformatted] Additional Resources: http://www.surgonc.org/ ; American Board of Medical Specialties, 2007, www.abms.org ; American Board of Surgery, 2007, http://www.absurgery.org/ Surgical oncology is a recognized fellowship subspecialty program of surgery. Separate board certification is not currently offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720006364 | William E Gillanders | Surgery | 4921 Parkview Pl Ste 7c, Ste 7c, Saint Louis, MO 63110-1032 | 2006-07-18 |
| 1225054455 | Timothy J Eberlein | Surgery | 216 S Kingshighway Blvd Fl 5, 5th Fl, Saint Louis, MO 63110-1026 | 2006-07-14 |
| 1922318989 | Fatema Ibrahim Almushawah | Surgery | 660 S Euclid Ave, Washington University /surgery Oncology, Saint Louis, MO 63110-1010 | 2010-10-08 |
| 1497955728 | Barbara Zarebczan Dull | Surgery | 4921 Parkview Pl, Saint Louis, MO 63110-1032 | 2007-07-24 |
| 1164440897 | Rebecca L Aft | Surgery | 216 S Kingshighway Blvd, Saint Louis, MO 63110-1026 | 2006-07-18 |
| 1376560839 | Bruce L Hall | Surgery | 4921 Parkview Pl Ste 5b, Ste 5b, Saint Louis, MO 63110-1032 | 2006-07-17 |
| 1750307054 | Julie A Margenthaler | Surgery | 216 S Kingshighway Blvd, Saint Louis, MO 63110-1026 | 2006-07-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063699502 | Saint Luke's Hospital Physician Billing Services, LLC | Surgery | 4323 Wornall, Peet Center Level 1, Kansas City, MO 64111 | 2008-01-28 |
| 1841274446 | Jovita Un Oruwari | Surgery | 3440 De Paul Ln Ste 104, Bridgeton, MO 63044-3546 | 2005-12-06 |
| 1144555723 | Jussuf T Kaifi | Surgery | One Hospital Dr, Columbia, MO 65212 | 2009-10-15 |
| 1033303276 | Richard Smith | Surgery | 1 Hospital Drive, Columbia, MO 65201-0001 | 2007-08-30 |
| 1427084227 | Aislinn Sue Vaughan | Surgery | 1475 Kisker Rd, Suite 185, Saint Charles, MO 63304-8781 | 2006-06-23 |
| 1285618876 | Marlys E Schuh | Surgery | 15945 Clayton Rd, Suite 120, Ballwin, MO 63011-2490 | 2005-12-06 |
| City | SAINT LOUIS |
| Zip Code | 63141 |
Please comment or provide details below to improve the information on MERCY CLINIC ST. LOUIS CANCER AND BREAST INSTITUTE, LLC.
| 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.