WILLIAM M IRVIN JR. (NPI# 1942392931) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942392931 |
| Entity Type | Individual |
| Full Name | WILLIAM M IRVIN JR. |
| Credential | MD |
| Practice Address |
11477 Olde Cabin Rd Ste 210 Saint Louis MO 63141-7129 |
| Mailing Address |
11477 Olde Cabin Rd Ste 210 Creve Coeur MO 63141-7129 |
| Practice Telephone | 3149975208 |
| Practice Fax Number | 3149975368 |
| Mailing Telephone | 3149975208 |
| Mailing Fax Number | 3149975368 |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2012-12-17 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0805X |
Psychiatry & Neurology Specialization: Geriatric Psychiatry |
2001010868 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD | 158049 | 01 | |
| RR MEDICARE | P00049380 | 01 | |
| UNITED HEALTHCARE | 1530953 | 01 | |
| MO | 205866304 | 05 | |
| HEALTHLINK | 484342 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902881600 | William R Irvin | Counselor | 7321 New Lagrange Rd, Suite 203, Louisville, KY 40222-4800 | 2005-12-14 |
| 1700903242 | William Johnson Irvin Jr. | Specialist | 14051 St Francis Blvd, Suite 2210, Midlothian, VA 23114-3201 | 2007-03-22 |
| 1093807059 | William Martin Irvin Sr. | Psychiatry & Neurology | 1201 Bellevue Ave, Saint Louis, MO 63117-1701 | 2006-09-28 |
| 1114938768 | William Sean Irvin | Physician Assistant | 112 John St, Suite 201, Easley, SC 29640-1472 | 2006-08-10 |
| 1285682740 | William S. Irvin | Internal Medicine | 401 N Keene St, Columbia, MO 65201-6625 | 2006-05-05 |
| 1588628580 | William Paul Irvin | Obstetrics & Gynecology | 12100 Warwick Blvd, Suite 202, Newport News, VA 23601-2365 | 2006-04-14 |
| Street Address |
11477 OLDE CABIN RD STE 210 |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63141-7129 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144713884 | Greenbrook Tms St Louis, LLC | Clinic/Center | 11477 Olde Cabin Rd Ste 210, Saint Louis, MO 63141-7129 | 2018-06-07 |
| 1043661184 | Jordan Leigh Malone | Registered Nurse | 11477 Olde Cabin Rd Ste 210, Saint Louis, MO 63141-7129 | 2016-06-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679102842 | Noor Ramadan | Pharmacist | 628 North New Ballad Road, Suite A, Creve Coeur, MO 63141 | 2020-04-08 |
| 1497381206 | Washington University | Durable Medical Equipment & Medical Supplies | 1044 North Mason Road, Suite 110/210, St. Louis, MO 63141 | 2020-03-13 |
| 1154956498 | Ashleigh Clendenny | Physician Assistant | Mercy Hospital St. Louis, 615 S New Ballas Rd, St. Louis, MO 63141 | 2020-03-06 |
| 1801429410 | Emili Lou Haley | Registered Nurse | 650 Maryville Drive, St Louis, MO 63141 | 2020-02-21 |
| 1629553110 | Rebecca Kathleen Pike | Social Worker | West County Psychological Associates, 12125 Woodcrest Executive Drive #110, St. Louis, MO 63141 | 2018-10-01 |
| 1649756099 | River City Sedation Associates, LLC | Nurse Anesthetist, Certified Registered | 12855 N 40 Dr Ste 150, Saint Louis, MO 63141 | 2018-07-18 |
| 1205333952 | Ear Care and Hearing of St. Louis | Hearing Aid Equipment | 11630 Studt Ave Ste 210, Creve Coeur, MO 63141 | 2018-04-10 |
| 1659897486 | Erin Goodman | Physical Therapist | 10560 Old Olive St. Rd, Suite 100, Creve Coeur, MO 63141 | 2017-08-14 |
| 1093230450 | Center for Urologic Surgery LLC | Clinic/Center | 12855 N 40 Dr Ste 100, Saint Louis, MO 63141 | 2017-08-07 |
| 1871016105 | Jacob Farley Tanner | Specialist/Technologist | 1054 Town and Four Parkway Dr, Creve Coeur, MO 63141 | 2017-07-19 |
| Find all providers in zip 63141 | ||||
| Taxonomy Code | 2084P0805X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Geriatric Psychiatry |
| Geriatric Psychiatry is a subspecialty with psychiatric expertise in prevention, evaluation, diagnosis and treatment of mental and emotional disorders in the elderly, and improvement of psychiatric care for healthy and ill elderly patients. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770743189 | Vadim Baram Md, Inc. | Psychiatry & Neurology | 10420 Old Olive Street Rd Ste 205, Saint Louis, MO 63141-5937 | 2008-06-10 |
| 1174008452 | Rita Khoury | Psychiatry & Neurology | 1438 S Grand Blvd, Saint Louis, MO 63104-1027 | 2018-10-02 |
| 1669691366 | St Louis University | Psychiatry & Neurology | 1438 S Grand Blvd, Saint Louis, MO 63104-1027 | 2007-04-24 |
| 1093727471 | St. Louis Psychiatry Doctors Group, LLC | Psychiatry & Neurology | 2639 Miami St, Saint Louis, MO 63118-3929 | 2006-08-13 |
| 1316990989 | Pratibha Nagenhalli Gurusiddaiya | Psychiatry & Neurology | 1 Jefferson Barracks Dr, Saint Louis, MO 63125-4181 | 2006-05-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902910615 | Dilip Gogineni | Psychiatry & Neurology | John J.pershing Vamc, 1500 Westwood Blvd, Poplar Bluff, MO 63901 | 2006-08-18 |
| 1013917525 | Andrew Lovy | Psychiatry & Neurology | 303 Weller St, Macon, MO 63552-1942 | 2005-07-26 |
| 1447452149 | Maritza Buenaver | Psychiatry & Neurology | 4801 E Linwood Blvd, 2jpp, Kansas City, MO 64128-2226 | 2007-06-04 |
| 1174587703 | Arturo G Quiason | Psychiatry & Neurology | 17221 E 23rd St S, #206, Independence, MO 64057-1803 | 2006-04-12 |
| City | SAINT LOUIS |
| Zip Code | 63141 |
Please comment or provide details below to improve the information on WILLIAM M IRVIN JR..
| 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.