ST LOUIS UNIVERSITY (NPI# 1932328796) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932328796 |
| Entity Type | Organization |
| Organization Name | ST LOUIS UNIVERSITY |
| Other Organization Name | SLUCARE DEPT OF PEDIATRIC ADOLESCENT MEDICINE |
| Practice Address |
1465 S Grand Blvd Saint Louis MO 63104-1003 |
| Mailing Address |
1831 Chestnut St Ste 650 Saint Louis MO 63103-2236 |
| Practice Telephone | 3142686406 |
| Mailing Telephone | 3149776828 |
| Enumeration Date | 2007-04-24 |
| Last Update Date | 2019-06-21 |
| Authorized Official Name | ALYCE LANXON (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 3149776828 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080A0000X |
Pediatrics Specialization: Adolescent Medicine |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| SLUCare Dept of Pediatric Adolescent Medicine | 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 |
1465 S GRAND BLVD |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63104-1003 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528676921 | Gunjanpreet Kaur | Student in an Organized Health Care Education/Training Program | 1465 S Grand Blvd, Saint Louis, MO 63104-1003 | 2020-07-21 |
| 1972128510 | Millicent Rose Palacios | Nurse Practitioner | 1465 S Grand Blvd, Saint Louis, MO 63104-1003 | 2020-06-09 |
| 1083241863 | Nathaniel Joseph Conner | Student in an Organized Health Care Education/Training Program | 1465 S Grand Blvd, Saint Louis, MO 63104-1003 | 2020-03-24 |
| 1467089177 | Stacy Kollanur Mathews | Student in an Organized Health Care Education/Training Program | 1465 S Grand Blvd, Saint Louis, MO 63104-1003 | 2020-03-24 |
| 1568099299 | Susan Aye Mya Oo | Student in an Organized Health Care Education/Training Program | 1465 S Grand Blvd, Saint Louis, MO 63104-1003 | 2020-03-24 |
| 1861029514 | Gregory Joseph Weissler II | Student in an Organized Health Care Education/Training Program | 1465 S Grand Blvd, Saint Louis, MO 63104-1003 | 2020-03-24 |
| 1154958874 | Brendan Michael Mcenery | Student in an Organized Health Care Education/Training Program | 1465 S Grand Blvd, Saint Louis, MO 63104-1003 | 2020-03-24 |
| 1316574049 | Satvika Mikkilineni | Student in an Organized Health Care Education/Training Program | 1465 S Grand Blvd, Saint Louis, MO 63104-1003 | 2020-03-24 |
| 1972130607 | Katherine Letha Randolph | Student in an Organized Health Care Education/Training Program | 1465 S Grand Blvd, Saint Louis, MO 63104-1003 | 2020-03-24 |
| 1346877081 | Samuel Ryan Richey | Student in an Organized Health Care Education/Training Program | 1465 S Grand Blvd, Saint Louis, MO 63104-1003 | 2020-03-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407469570 | Family Care Health Centers | Clinic/Center | 2717 Sidney Street, St. Louis, MO 63104 | 2020-08-28 |
| 1023638038 | Laura Ann Humphrey | Physician Assistant | Allied Health Building 3437 Caroline Street, Room 3015, Saint Louis, MO 63104 | 2020-04-20 |
| 1174187264 | Ahsan Ali | Student in an Organized Health Care Education/Training Program | 1438 South Grand Blvd, Monteleone Hall, St. Louis, MO 63104 | 2019-04-24 |
| 1205359916 | Brenda Eve Ladin | Behavior Technician | 1221 Allen Market Lane Rear, St. Louis, MO 63104 | 2017-07-25 |
| 1841722063 | Gustavo G Mendez | Student in an Organized Health Care Education/Training Program | 1465 South Grand Bulevard Rm 2717, Ssm Health Cardinal Glennon Children's Hospital, Saint Louis, MO 63104 | 2017-03-28 |
| 1053776716 | Carmella Harper | Respiratory Therapist, Certified | 2678 Park Ave, St Louis, MO 63104 | 2015-12-23 |
| 1922485986 | Alexander Tremont | Internal Medicine | 1402 S Grand Blvd Rm M260, Saint Louis, MO 63104 | 2015-04-29 |
| 1306233341 | Healthcare R Us | Home Health | 2859 Sidney St, St Louis, MO 63104 | 2015-04-16 |
| 1396159091 | Daniela Hermelin | Pathology | 1402 South Grane, St. Louis, MO 63104 | 2014-06-20 |
| 1992117881 | Kelly Denise Durbin | Social Worker | 1920 S 7th St, Saint Louis, MO 63104 | 2014-05-27 |
| Find all providers in zip 63104 | ||||
| Taxonomy Code | 2080A0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Adolescent Medicine |
| A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. |
| 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) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114048154 | Affton Medical Clinic | Pediatrics | 59 Grasso Plz, Saint Louis, MO 63123-3107 | 2007-04-03 |
| 1760556708 | Ariane E May | Pediatrics | 4055 Lindell Blvd, Saint Louis, MO 63108-3201 | 2006-11-20 |
| 1518030097 | Jill M. Baer | Pediatrics | 3009 N Ballas Rd, Suite 257-c, Saint Louis, MO 63131-2322 | 2006-11-15 |
| 1801999768 | Joyce D Johnson | Pediatrics | 6744 Clayton Rd, Saint Louis, MO 63117-1637 | 2006-09-06 |
| 1730295759 | Joseph Prusaczyk | Pediatrics | 13035 Olive Blvd, Saint Louis, MO 63141-6173 | 2006-08-22 |
| 1649292780 | Sarah Ann Tycast | Pediatrics | 1 Childrens Pl, Saint Louis, MO 63110-1002 | 2006-07-25 |
| 1528081544 | Lynn K White | Pediatrics | 1 Childrens Pl, Saint Louis, MO 63110-1002 | 2006-07-25 |
| 1023036746 | Maryjo Hernandez-zipfel | Pediatrics | 4055 Lindell Blvd, Saint Louis, MO 63108-3201 | 2006-07-18 |
| 1750310439 | Amal F Antoun | Pediatrics | 1717 Biddle St, Saint Louis, MO 63106-3454 | 2006-07-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366670796 | Fernando Fernandez, M. D. PC | Pediatrics | 2750 Clay Edwards Dr Ste 320, North Kansas City, MO 64116-3259 | 2009-06-24 |
| 1073733069 | Kelly Jo Meier | Pediatrics | 2719 E 32nd St, Joplin, MO 64804-3131 | 2007-05-01 |
| 1851417794 | Shari L Smith | Pediatrics | 200 Castle Drive, Joplin, MO 64804-9115 | 2007-03-22 |
| 1811076763 | Nedra Diann Twillie | Pediatrics | 415 Burkarth Rd Ste D, Warrensburg, MO 64093-3101 | 2006-11-03 |
| 1740209162 | Nancy Elizabeth Holmes | Pediatrics | 8888 Ladue Road, Suite 130, St. Louis, MO 63124 | 2006-07-18 |
| 1194770883 | Ann A Gassman | Pediatrics | 503 N Scott Ave, Belton, MO 64012-1730 | 2006-05-23 |
| 1841299161 | Bryson Roy Mchardy Jr. | Pediatrics | 100 Medical Dr, Hannibal, MO 63401-6877 | 2005-07-19 |
| 1245239797 | Jeffrey Paul Yannette | Pediatrics | 821 Sw Lemans Lane, Lees Summit, MO 64082 | 2005-07-18 |
| 1679570618 | Carolyn Ann Ellsworth | Pediatrics | 312 N Kentucky St, West Plains, MO 65775-2073 | 2005-07-06 |
| 1528064102 | Joseph William Stafford Jr. | Pediatrics | 312 N Kentucky Ave, West Plains, MO 65775-2073 | 2005-06-28 |
| Find all providers with the same taxonomy | ||||
| City | SAINT LOUIS |
| Zip Code | 63104 |
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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.