ST LOUIS UNIVERSITY (NPI# 1932311826) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932311826 |
| Entity Type | Organization |
| Organization Name | ST LOUIS UNIVERSITY |
| Other Organization Name | SLUCARE DEPT OF OTOLARYNGOLOGY PSG W/I HEAD AND NECK |
| Practice Address |
3660 Vista Ave Saint Louis MO 63110-2540 |
| Mailing Address |
1831 Chestnut St Ste 650 Saint Louis MO 63103-2236 |
| Practice Telephone | 3149775110 |
| Mailing Telephone | 3149776828 |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2019-06-21 |
| Authorized Official Name | ALYCE LANXON (EXEUCTIVE DIRECTOR) |
| Authorized Official Telephone | 3149776828 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207YX0007X |
Otolaryngology Specialization: Plastic Surgery within the Head & Neck |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| SLUCARE DEPT OF OTOLARYNGOLOGY PSG W/I HEAD AND NECK | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487869863 | St Louis University | Eyewear Supplier (Equipment, not the service) | 1755 South Grand, St Louis, MO 63104 | 2007-05-11 |
| 1194892463 | St Louis University | Orthopaedic Surgery | 1831 Chestnut St Ste 650, Saint Louis, MO 63103 | 2006-11-29 |
| 1093894842 | St Louis University | Internal Medicine | 10 Franklin, Washington, MO 63090 | 2006-11-03 |
| 1417035759 | St Louis University | Audiologist | 3750 Lindell, St Louis, MO 63108 | 2006-11-02 |
| 1992778237 | St Louis University | Urology | 3655 Vista Ave, Saint Louis, MO 63110-2539 | 2006-02-08 |
| 1164495412 | St Louis University | Pathology | 1402 South Grand, St Louis, MO 63104 | 2006-02-08 |
| 1801869136 | St Louis University | Psychiatry & Neurology | 1438 S Grand Blvd, Saint Louis, MO 63104-1027 | 2006-02-08 |
| 1740253095 | St Louis University | Dermatology | 1755 S Grand Blvd, Saint Louis, MO 63104-1540 | 2006-02-08 |
| 1184266413 | St Louis University | Pediatrics | 1465 S Grand Blvd, Saint Louis, MO 63104-1003 | 2019-10-08 |
| 1184908865 | St Louis University | Urology | 1465 S Grand Blvd, Saint Louis, MO 63104-1003 | 2011-09-29 |
| Street Address |
3660 VISTA AVE |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63110-2540 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871582692 | Alan P K Wild | Otolaryngology | 3660 Vista Ave, Ste. 312, Saint Louis, MO 63110 | 2005-10-14 |
| 1922627207 | Emily Bayliss Worrall | Student in an Organized Health Care Education/Training Program | 3660 Vista Ave, Saint Louis, MO 63110-2540 | 2020-04-16 |
| 1508485988 | Jackson Jeffrey Meland | Student in an Organized Health Care Education/Training Program | 3660 Vista Ave, Saint Louis, MO 63110-2540 | 2020-04-15 |
| 1316566748 | Katherine Elizabeth Oberhelman | Student in an Organized Health Care Education/Training Program | 3660 Vista Ave, Saint Louis, MO 63110-2540 | 2020-04-15 |
| 1063031664 | Elizabeth Jane De Quetteville Robin | Student in an Organized Health Care Education/Training Program | 3660 Vista Ave, Saint Louis, MO 63110-2540 | 2020-04-14 |
| 1053930586 | Tim Brotherton Jr. | Student in an Organized Health Care Education/Training Program | 3660 Vista Ave, Saint Louis, MO 63110-2540 | 2020-04-14 |
| 1285253328 | Eugene Chiemeka Nwankwo Jr. | Student in an Organized Health Care Education/Training Program | 3660 Vista Ave, Saint Louis, MO 63110-2540 | 2020-04-09 |
| 1124647318 | Christian Hendrix | Student in an Organized Health Care Education/Training Program | 3660 Vista Ave, Saint Louis, MO 63110-2540 | 2020-04-08 |
| 1851920730 | Kellen J Smutz | Student in an Organized Health Care Education/Training Program | 3660 Vista Ave, Saint Louis, MO 63110-2540 | 2020-04-03 |
| 1487283172 | Abhinav Reddy | Student in an Organized Health Care Education/Training Program | 3660 Vista Ave, Saint Louis, MO 63110-2540 | 2020-04-03 |
| 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 | 207YX0007X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| Specialization | Plastic Surgery within the Head & Neck |
| An otolaryngologist with additional training in plastic and reconstructive procedures within the head, face, neck and associated structures, including cutaneous head and neck oncology and reconstruction, management of maxillofacial trauma, soft tissue repair and neural surgery. The field is diverse and involves a wide age range of patients, from the newborn to the aged. While both cosmetic and reconstructive surgeries are practiced, there are many additional procedures which interface with them. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy is currently provided in the subspecialty of Otolaryngology/Facial Plastic Surgery (see Taxonomy Code 207YX0905X) |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477571198 | Gregory H Branham | Otolaryngology | 1020 N Mason Rd Ste 205, Ste 205, Saint Louis, MO 63141-6300 | 2006-07-18 |
| 1306811179 | Laxmeesh D Nayak | Otolaryngology | 607 S Lindbergh Blvd, Saint Louis, MO 63131-2734 | 2006-02-22 |
| 1497747521 | Donald G Sessions | Otolaryngology | 1960 Grassy Ridge Rd, Saint Louis, MO 63122-3539 | 2005-08-16 |
| 1689872368 | John Chi | Otolaryngology | 1020 N Mason Rd Ste 205, Ste 205, Saint Louis, MO 63141-6300 | 2007-07-05 |
| 1215928114 | James H Boyd | Otolaryngology | 607 S New Ballas Rd, Ste 2300, Saint Louis, MO 63141-8219 | 2005-10-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669527610 | Head & Neck Surgery of Kansas City P A | Otolaryngology | 17053 S Us Highway 71, Suite 206, Belton, MO 64012-4631 | 2007-01-23 |
| 1952455065 | Head & Neck Surgery of Kansas City P A | Otolaryngology | 930 Carondelet Dr Bldg C, Suite 305, Kansas City, MO 64114-4855 | 2007-01-23 |
| 1316144223 | John Judson Barclay Jr. | Otolaryngology | 5301 Faraon St, Ste 160, Saint Joseph, MO 64506-3512 | 2007-07-03 |
| 1699978767 | Peter E. Shapiro, M.d., L.L.C. | Otolaryngology | 6675 Holmes Rd, Suite 410, Kansas City, MO 64131-1150 | 2007-06-07 |
| 1871715953 | Branson Ear Nose & Throat | Otolaryngology | 545 Branson Landing Blvd, Suite 410, Branson, MO 65616 | 2007-05-02 |
| 1396836284 | Michael E Bays | Otolaryngology | 545 Branson Landing Blvd, Suite 410, Branson, MO 65616-2035 | 2006-09-27 |
| 1871579037 | Nathan David Burroughs | Otolaryngology | 9411 N Oak Trfy, Ste 202, Kansas City, MO 64155-2262 | 2005-12-20 |
| 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.