KAITLIN J PORTZ (NPI# 1912528100) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912528100 |
| Entity Type | Individual |
| Full Name | KAITLIN J PORTZ |
| Other Name | KAITLIN J HUELSMAN |
| Credential | PHD |
| Practice Address |
4921 Parkview Pl Saint Louis MO 63110-1032 |
| Mailing Address |
105 S High St Shiloh IL 62269-2920 |
| Practice Telephone | 3147475587 |
| Enumeration Date | 2020-04-29 |
| Last Update Date | 2020-06-10 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103T00000X | Psychologist | 2018043609 | MO | Behavioral Health & Social Service Providers |
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
071.010140 | IL | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 105 S High St, Shiloh, IL 622692920 | 8335710951 | |
| 4921 Parkview Pl, Saint Louis, MO 631101032 | 3147475587 |
| Street Address |
4921 PARKVIEW PL |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63110-1032 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679576359 | Peter D Weiss | Internal Medicine | 4921 Parkview Pl, Ste 14b, Saint Louis, MO 63110-1032 | 2005-05-24 |
| 1881291284 | Brandy R Boyle | Nurse Practitioner | 4921 Parkview Pl, Saint Louis, MO 63110-1032 | 2020-10-08 |
| 1225635527 | Faith Fields | Nurse Practitioner | 4921 Parkview Pl, Saint Louis, MO 63110-1032 | 2020-10-08 |
| 1437785979 | Jodi Granger | Internal Medicine | 4921 Parkview Pl, Saint Louis, MO 63110-1032 | 2020-03-17 |
| 1174159701 | Grace Catherine Keane | Student in an Organized Health Care Education/Training Program | 4921 Parkview Pl, Saint Louis, MO 63110-1032 | 2020-03-16 |
| 1740828581 | Michelle Anne Maurer | Nurse Practitioner | 4921 Parkview Pl, Saint Louis, MO 63110-1032 | 2019-12-11 |
| 1205472487 | Sarah Bohme | Nurse Practitioner | 4921 Parkview Pl, Saint Louis, MO 63110-1032 | 2019-11-21 |
| 1972145787 | Emily Sarah Cherry | Nurse Practitioner | 4921 Parkview Pl, Ste 11c, Saint Louis, MO 63110-1032 | 2019-10-14 |
| 1871144832 | Sara Ranae Kellahan | Nurse Practitioner | 4921 Parkview Pl, Ste 5c, Saint Louis, MO 63110-1032 | 2019-09-21 |
| 1730733692 | William Thomas Lentz | Nurse Practitioner | 4921 Parkview Pl, Saint Louis, MO 63110-1032 | 2019-07-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659971992 | Carrie Ellen Smith | Nurse Practitioner | Mailstop 90-00-174, One Barnes-jewish Plaza, St. Louis, MO 63110 | 2020-10-27 |
| 1881210466 | Michelle Amanda Freilich | Internal Medicine | Barnes-jewish Plaza, St. Louis, MO 63110 | 2020-06-19 |
| 1245856046 | Jeevin Shahi | Radiology | 3685 Vista Avenue, Center for Radiation Medicine, St. Louis, MO 63110 | 2020-06-18 |
| 1497371314 | Wilson Eduardo Rodriguez | Student in an Organized Health Care Education/Training Program | 1008 S. Spring, St Louis, MO 63110 | 2020-06-17 |
| 1578184065 | Kathryn Kay Lindsay | Registered Nurse | Saint Louis University Dept of Surgery, 3635 Vista Ave 3dt, St Louis, MO 63110 | 2020-05-06 |
| 1881232700 | Ashley Diane Pace | Nurse Practitioner | 1 Parkview Place, Shoenberg 6900, St. Louis, MO 63110 | 2019-12-11 |
| 1619520418 | Krithika Damodar Shenoy | Pathology | 660 Euclid Avenue, One Barnes Jewish Hospital Plaza, St. Louis, MO 63110 | 2019-07-20 |
| 1467912550 | Ian Ferguson | Dermatology | 660 S Euclid Ave., Cb 8123, St. Louis, MO 63110 | 2019-03-23 |
| 1760978688 | Ihab Hassanieh | Student in an Organized Health Care Education/Training Program | 33660 Vista Ave, St. Louis, MO 63110 | 2018-07-03 |
| 1336634500 | Martin K Mwangi | Pediatrics | 1 Childrens Place, 3s34, St. Louis, M, MO 63110 | 2018-06-28 |
| Find all providers in zip 63110 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174147649 | Melissa Turkel | Psychologist | 915 N Grand Blvd # 116-jc, Saint Louis, MO 63106-1621 | 2020-06-01 |
| 1629600085 | Dr Richard Heise LLC | Psychologist | 10621 Midland Manor Ct, Saint Louis, MO 63114-1202 | 2020-02-04 |
| 1598302226 | Taylor Montgomery | Psychologist | 12837 Flushing Meadows Dr Ste 220, Saint Louis, MO 63131-1824 | 2019-12-02 |
| 1265917884 | Gillian Sloane Mayersohn | Psychologist | 1 Childrens Pl Ste 3n14, Saint Louis, MO 63110-1002 | 2018-09-28 |
| 1265944466 | Brittany Jacobson | Psychologist | 1 Jefferson Barracks Rd # 116b, Saint Louis, MO 63125-4181 | 2017-10-27 |
| 1801316690 | David Howard Morris | Psychologist | 4921 Parkview Pl # 90-35703, Saint Louis, MO 63110-1032 | 2017-06-22 |
| 1144774647 | Carolyn Ashley Myles Versical | Psychologist | 26 Godwin Ln, Saint Louis, MO 63124 | 2016-08-12 |
| 1376980326 | Joshua Paul Beaman-kogan | Psychologist | 1 University Blvd # 232, Stadler Hall, Saint Louis, MO 63121-4400 | 2013-05-31 |
| 1104176064 | Brooke Kraushaar,psy.d,llc | Psychologist | 6321 Alamo Ave, Saint Louis, MO 63105-3103 | 2012-09-18 |
| 1326335837 | Jeremiah Weinstock | Psychologist | 3511 Laclede Ave, Shannon Hall, Room 208, Saint Louis, MO 63103-2010 | 2011-07-05 |
| Find all providers in SAINT LOUIS | ||||
| City | SAINT LOUIS |
| Zip Code | 63110 |
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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.