RICHARD H. ROETTGER (NPI# 1932150638) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932150638 |
| Entity Type | Individual |
| Full Name | RICHARD H. ROETTGER |
| Credential | M.D. |
| Practice Address |
12266 De Paul Dr Ste 305 Bridgeton MO 63044 |
| Mailing Address |
Po Box 955534 Saint Louis MO 63195-5534 |
| Practice Telephone | 3147700991 |
| Enumeration Date | 2006-05-15 |
| Last Update Date | 2020-10-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208600000X | Surgery | 2014006605 | MO | Allopathic & Osteopathic Physicians |
| N | 208600000X | Surgery | 23291 | SC | Allopathic & Osteopathic Physicians |
| Y | 2086S0127X |
Surgery Specialization: Trauma Surgery |
2014006605 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | BCBS OF SC ID | 576007863077 | 01 |
| SC | N01002 | 05 | |
| SC | CIGNA ID | 3087952 | 01 |
| SC | RR MEDICARE | 020052517 | 01 |
| SC | AETNA ID | 4279822 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 35 Medical Ridge Dr, Greenville, SC 296054268 | 8642320055 |
| Street Address |
12266 DE PAUL DR STE 305 |
| City | BRIDGETON |
| State | MO |
| Zip Code | 63044 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558881052 | Amber Marie Owens | Nurse Practitioner | 12266 De Paul Dr Ste 305, Bridgeton, MO 63044-2514 | 2017-06-26 |
| 1164804035 | Kyle Christensen | Surgery | 12266 De Paul Dr Ste 305, Bridgeton, MO 63044-2514 | 2015-06-26 |
| 1619231636 | Betsy L Krebs | Surgery | 12266 De Paul Dr Ste 305, Bridgeton, MO 63044-2514 | 2012-06-25 |
| 1194765578 | Thomas P Bocchini | Radiology | 12266 De Paul Dr Ste 305, Bridgeton, MO 63044-2514 | 2006-06-07 |
| 1588603435 | Hope Rasque | Surgery | 12266 De Paul Dr Ste 305, Bridgeton, MO 63044-2514 | 2006-06-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073150017 | Zoe Marie Wadsworth | Nurse Practitioner | 12255 Depaul Dr Suite 300, Bridgeton, MO 63044 | 2019-12-10 |
| 1609412451 | Beyond Better, Best Home Health Care Services, Limited Liability Corpo | In Home Supportive Care | 3430 Mckelvey Road Ste B, Bridgeton, MO 63044 | 2019-11-26 |
| 1275189078 | Delicate Angels Home Health LLC | Home Health | 11726 St. Charles Rock Road Suite G, Bridgeton, MO 63044 | 2019-08-16 |
| 1588210082 | Nicholas Huber | Physical Therapist | 12349 Depaul Dr., Ste. 110, Bridgeton, MO 63044 | 2019-08-12 |
| 1124688858 | Michelle Bassett | Registered Nurse | 11520 St. Charles Rock Rd., Suite 106, Bridgeton, MO 63044 | 2019-06-14 |
| 1336703883 | Elena A Barrow | Nurse Practitioner | 12255 Depaul Dr, Suite 260, Bridgeton, MO 63044 | 2019-04-30 |
| 1487123105 | Laura N Steiner | Registered Nurse | Gateway Pediatrics, Ltd, 12255 Depaul Drive, Suite 460 North Medical Building, Bridgeton, MO 63044 | 2018-11-26 |
| 1205310950 | Danielle Mathis | Nurse Practitioner | 3440 Depaul Lane Suite 201, Bridgeton, MO 63044 | 2018-09-19 |
| 1588163570 | Thoughts Out Loud Counseling, LLC | Social Worker | 11520 St. Charles Rock Road Suite 101, Bridgeton, MO 63044 | 2018-02-06 |
| 1912411430 | Breanna Victoria Hayes | Counselor | 3165 Mckevley Road, Suite 200, Bridgeton, MO 63044 | 2017-11-20 |
| Find all providers in zip 63044 | ||||
| Taxonomy Code | 2086S0127X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Trauma Surgery |
| Trauma surgery is a recognized subspecialty of general surgery. Trauma surgeons are physicians who have completed a five-year general surgery residency and usually continue with a one to two year fellowship in trauma and/or surgical critical care, typically leading to additional board certification in surgical critical care. There is no trauma surgery board certification at this point. To obtain board certification in surgical critical care, a fellowship in surgical critical care or anesthesiology critical care must be completed during or after general surgery residency. |
| Notes: Source: American Board of Surgery, 2007 [1/1/2008: definition added, source added] Additional Resources: http://www.absurgery.org/. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861810111 | Abbie May Jensen | Surgery | 615 S New Ballas Rd Ste 560a, Saint Louis, MO 63141-8221 | 2014-04-03 |
| 1457521478 | Manuel Almendral Castasus | Surgery | 884 Woodsmill Road, Ttg Locum Tenens, Ballwin, MO 63011 | 2008-03-05 |
| 1205907359 | Dennis M Arce Md | Surgery | 6420 Prospect Ave Ste 311, Kansas City, MO 64132-4130 | 2006-11-12 |
| 1811087547 | Hillary Aa Chollet Md PC | Surgery | 6400 Prospect Ave Ste 338, Kansas City, MO 64132-1100 | 2006-10-13 |
| 1063468361 | Midwest Trauma Services, LLC | Surgery | 2330 East Meyer Blvd, T-207, Kansas City, MO 64132-4147 | 2006-05-26 |
| 1285684167 | Pascal Nyachowe | Surgery | 4320 Wornall Rd Ste 5320, Kansas City, MO 64111-5941 | 2006-05-11 |
| 1760934889 | Glenarm Acute Surgical Specialists LLC | Surgery | 2316 E Meyer Blvd, Kansas City, MO 64132-1136 | 2016-10-25 |
| 1194019968 | Kevin Clay Christian | Surgery | 3800 S National Ave, 4th Floor, Springfield, MO 65807-5209 | 2011-06-08 |
| 1316262793 | Jennifer Marie Laplante | Surgery | 400 1st Capitol Dr Ste 201, Saint Charles, MO 63301-2882 | 2010-03-29 |
| 1922236314 | Jeffrey Ray Simpson | Surgery | 2330 E Meyer Blvd, Ste 207, Kansas City, MO 64132-1132 | 2009-06-24 |
| Find all providers with the same taxonomy | ||||
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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.