ROD EVAN PELLENBERG (NPI# 1902126097) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902126097 |
| Entity Type | Individual |
| Full Name | ROD EVAN PELLENBERG |
| Credential | M.D. |
| Practice Address |
11365 Dorsett Rd. Maryland Heights MO 63043 |
| Mailing Address |
11365 Dorsett Road Maryland Heights MO 63043 |
| Practice Telephone | 3148726400 |
| Mailing Telephone | 3148726400 |
| Enumeration Date | 2010-06-11 |
| Last Update Date | 2018-07-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0202X |
Pediatrics Specialization: Pediatric Cardiology |
2017013705 | MO | Allopathic & Osteopathic Physicians |
| Street Address |
11365 DORSETT RD. |
| City | MARYLAND HEIGHTS |
| State | MO |
| Zip Code | 63043 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275550717 | Brian J. Kelly | Pediatrics | 11365 Dorsett Rd., Maryland Heights, MO 63043 | 2006-07-17 |
| 1669809133 | Rachael Lisa Juehring | Psychologist | 11365 Dorsett Rd., Maryland Heights, MO 63043 | 2013-09-30 |
| 1972880003 | Mitzie E Graeler | General Acute Care Hospital | 11365 Dorsett Rd., Maryland Heights, MO 63043 | 2011-11-03 |
| 1346411212 | Barbara Ann Champion | Nurse Practitioner | 11365 Dorsett Rd., Maryland Heights, MO 63043 | 2008-03-18 |
| 1093925588 | Amy C. Zimmermann | Physical Medicine & Rehabilitation | 11365 Dorsett Rd., Maryland Heights, MO 63043 | 2007-05-23 |
| 1336367226 | Eugene Evra | Physical Medicine & Rehabilitation | 11365 Dorsett Rd., Maryland Heights, MO 63043 | 2007-04-23 |
| 1740304948 | Elizabeth R Downey | Registered Nurse | 11365 Dorsett Rd., Maryland Heights, MO 63043 | 2007-03-16 |
| 1558468892 | Connie D Simmons | Pediatrics | 11365 Dorsett Rd., Maryland Heights, MO 63043 | 2006-09-20 |
| 1285749333 | Lynda M Brady | Specialist | 11365 Dorsett Rd., Maryland Heights, MD 63043 | 2006-08-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861026098 | Sana Lake Recovery Center, LLC | Community/Behavioral Health | 140 Weldon Parkway, Maryland Heights, MO 63043 | 2020-02-26 |
| 1124658257 | Amadu Barrie | Nurse Practitioner | 134 Midland Avenue, Maryland Heights, MO 63043 | 2020-01-16 |
| 1770004707 | Taylor Anne Jordan | Specialist/Technologist | 1885 Mckelvey Hill Dr., Apt 303, Maryland Heights, MO 63043 | 2017-06-29 |
| 1528507167 | Erica K Mazurkiewicz | Counselor | 12061 Dorsett, Maryland Heights, MO 63043 | 2017-02-15 |
| 1851756217 | Crpt, LLC | Physical Therapist | 12674 Dorsett Road, Maryland Heights, MO 63043 | 2015-12-29 |
| 1871930032 | Rachel Michele Gill | Chiropractor | 11d Worthington Access Dr., St. Louis, MO 63043 | 2013-05-29 |
| 1487913299 | John Martin Dds | Dentist | 12131 Dorsett, St 211, Maryland Heights, MO 63043 | 2012-05-14 |
| 1518287648 | Pharmacy Services Inc. | Pharmacist | 212 Millwell Dr., Suite A, St. Louis, MO 63043 | 2010-06-11 |
| 1447578000 | Rxoutreach | Pharmacy | 3171-3183 Riverport Tech Center Dr, Maryland Heights, MO 63043 | 2010-05-06 |
| 1811129257 | Gene Paul Barbour | Internal Medicine | 1 Reading, Marilyn Heights, MO 63043 | 2009-08-19 |
| Find all providers in zip 63043 | ||||
| Taxonomy Code | 2080P0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Cardiology |
| A pediatric cardiologist provides comprehensive care to patients with cardiovascular problems. This specialist is skilled in selecting, performing and evaluating the structural and functional assessment of the heart and blood vessels, and the clinical evaluation of cardiovascular disease. |
| 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 Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) was provided by the American Osteopathic Board of Pediatrics. The Certification is no longer offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669023388 | Kansas City Pediatric Cardiology Associates | Pediatrics | 4150 N Mulberry Dr Ste 150, Kansas City, MO 64116-1764 | 2019-09-24 |
| 1205255379 | Manoj Parimi | Pediatrics | 621 S New Ballas Rd Ste 198a, Saint Louis, MO 63141-8255 | 2014-04-15 |
| 1144399338 | Mercy Clinic Children's Heart Center, LLC | Pediatrics | 621 S New Ballas Road, Suite 198-a, St Louis, MO 63141-8255 | 2006-11-06 |
| 1255389920 | William Baker Drake IIi | Pediatrics | 4150 N Mulberry Dr, Suite 150, Kansas City, MO 64116-1779 | 2006-05-05 |
| 1063460079 | Catherine Ong Simon | Pediatrics | 2401 Gillham, Children's Mercy Hospital, Kansas City, MO 64108 | 2006-05-04 |
| 1467458943 | Allan James Shapiro | Pediatrics | 500 N Keene St, Ste 207, Columbia, MO 65201-8105 | 2005-06-21 |
| 1710983291 | Armin Jared Wagman | Pediatrics | 4350 S National Ave, # C-100, Springfield, MO 65810-2607 | 2005-06-21 |
| 1356792881 | Maria G Kiaffas | Pediatrics | 2401 Gillham Rd., Dept. of Cardiology, Kansas City, MO 64108-4619 | 2016-06-27 |
| 1841623626 | John Papagiannis | Pediatrics | 2401 Gillham Rd, Kansas City, MO 64108-4619 | 2013-08-15 |
| 1730522723 | Matthew Louis Moehlmann | Pediatrics | 2401 Gillham Rd, Kansas City, MO 64108-4619 | 2013-04-09 |
| Find all providers with the same taxonomy | ||||
| City | MARYLAND HEIGHTS |
| Zip Code | 63043 |
Please comment or provide details below to improve the information on ROD EVAN PELLENBERG.
| 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.