ST LOUIS UNIVERSITY


Address: 1755 S Grand Blvd, Saint Louis, MO 63104-1540
Phone: 3142563400

ST LOUIS UNIVERSITY (NPI# 1962624585) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1962624585
Entity Type Organization
Organization Name ST LOUIS UNIVERSITY
Other Organization Name SLUCARE DEPT OF DERMATOLOGY-MOHS SURGERY
Practice Address 1755 S Grand Blvd
Saint Louis
MO 63104-1540
Mailing Address 1831 Chestnut St Ste 650
Saint Louis
MO 63103-2236
Practice Telephone 3142563400
Mailing Telephone 3149776828
Enumeration Date 2007-05-03
Last Update Date 2019-06-20
Authorized Official Name ALYCE LANXON (EXECUTIVE DIRECTOR)
Authorized Official Telephone 3149776828
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207ND0101X Dermatology
Specialization: MOHS-Micrographic Surgery
Allopathic & Osteopathic Physicians

Other Provider/Organization Names

Other Name Type Code
SLUCARE DEPT OF DERMATOLOGY-MOHS SURGERY Doing Business As Name - Organization

Other Provider IDs and Locations

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

Office Location

Street Address 1755 S GRAND BLVD
City SAINT LOUIS
State MO
Zip Code 63104-1540

Providers in the same location

NPI Name Taxonomy Address Enumeration
1740253095 St Louis University Dermatology 1755 S Grand Blvd, Saint Louis, MO 63104-1540 2006-02-08
1295363372 Jordan Benjamin Leynes Physician Assistant 1755 S Grand Blvd, Saint Louis, MO 63104-1540 2020-04-01
1366936411 Gabriela Madeleine Morris Internal Medicine 1755 S Grand Blvd, Saint Louis, MO 63104 2018-06-20
1891228425 Madelyn Farrell Oliver Jeter Student in an Organized Health Care Education/Training Program 1755 S Grand Blvd, Saint Louis, MO 63104-1540 2017-04-10
1982079810 Claudia Sophia Morr Verenzuela Dermatology 1755 S Grand Blvd, Saint Louis, MO 63104-1540 2015-12-03
1528447125 Kristin Colleen Smith Dermatology 1755 S Grand Blvd, Saint Louis, MO 63104-1540 2015-05-28
1205213253 Ashley Mcwilliams Student in an Organized Health Care Education/Training Program 1755 S Grand Blvd, Saint Louis, MO 63104-1540 2015-04-29
1154714202 Heidi Elaine Roeder Physician Assistant 1755 S Grand Blvd, Saint Louis, MO 63104-1540 2015-03-13
1134534811 Jennifer Albus Fehlman Dermatology 1755 S Grand Blvd, Saint Louis, MO 63104-1540 2014-06-21
1124446588 Saniya Shaikh Student in an Organized Health Care Education/Training Program 1755 S Grand Blvd, Saint Louis, MO 63104-1540 2014-04-02
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Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 207ND0101X
Grouping Allopathic & Osteopathic Physicians
Classification Dermatology
Specialization MOHS-Micrographic Surgery

Taxonomy Definition

The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S.
Notes: Source: American College of Mohs Surgery, 2007 [1/1/2008: added definition, added source] Additional Resources: Additional Resources: http://www.mohscollege.org/; American Board of Dermatology, 2007. http://www.abderm.org/

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1124223011 Ramona Behshad Dermatology 2315 Dougherty Ferry Rd Ste 200a, Saint Louis, MO 63122-3383 2007-06-19
1891179040 Forefront Dermatology, S.c. Dermatology 12855 N 40 Dr, Suite 180, Saint Louis, MO 63141 2015-07-17
1649542150 Erickson Skin Surgery & Dermatology, LLC Dermatology 555 N New Ballas Rd, Suite 260, Saint Louis, MO 63141-6825 2012-01-30
1184908246 William G. Hart, Jr., Inc. Dermatology 621 S New Ballas Rd, Ste. 676a, Saint Louis, MO 63141-8232 2011-10-06
1326332123 Ethan C Levin Dermatology 969 N Mason Rd Ste 200, Saint Louis, MO 63141-6338 2011-06-09
1265695589 Daniel Lawrence Christiansen Dermatology 12855 N 40 Dr, Suite 180, Saint Louis, MO 63141-8657 2008-07-07
1659304061 St. Louis Dermatology and Surgery Center, PC Dermatology 12855 N 40 Dr, Suite 180, Saint Louis, MO 63141-8635 2006-07-09

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1982140265 Forefront Dermatology, S.c. Dermatology 8567 Watson Rd, Webster Groves, MO 63119 2017-01-11
1619424744 Forefront Dermatology, S.c. Dermatology 5700 Mexico Rd, Suite 14, Saint Peters, MO 63376 2016-09-07
1730352394 First Capitol Dermatology, L.L.C. Dermatology 901 S. 5th St., First Capitol Dermatology, L.L.C., St. Charles, MO 63301-2416 2008-04-03
1518925312 Henry W Clever IIi Dermatology 901 S 5th St, St Charles, MO 63301 2006-05-02
1013912906 George J. Hruza Dermatology 1001 Chesterfield Pkwy E, Ste 101, Chesterfield, MO 63017-2041 2005-06-16
1225482839 United Skin Specialists Missouri Ltd, PC Dermatology 1001 Chesterfield Pkwy E, Suite 101, Chesterfield, MO 63017-2167 2016-04-20
1003290156 Forefront Dermatology, S.c. Dermatology 1223 Maple St, Farmington, MO 63640 2015-07-17
1013145234 Andrew Michael Basnett Dermatology 401 N Keene St, Columbia, MO 65201 2009-06-25
1043462591 Dermatology Office PC Dermatology 225 Physicians Park, Suite 203, Poplar Bluff, MO 63901-3956 2008-10-15
1760641179 Quincy Physicians & Surgeons Clinic, Sc Dermatology 163 Medical Dr, Hannibal, MO 63401-6884 2008-06-02
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Competitor

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City SAINT LOUIS
Zip Code 63104

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Dataset Information

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.

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