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).
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 |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207ND0101X |
Dermatology Specialization: MOHS-Micrographic Surgery |
Allopathic & Osteopathic Physicians |
Other Name | Type Code |
---|---|
SLUCARE DEPT OF DERMATOLOGY-MOHS SURGERY | 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 |
1755 S GRAND BLVD |
City | SAINT LOUIS |
State | MO |
Zip Code | 63104-1540 |
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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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 | 207ND0101X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Dermatology |
Specialization | MOHS-Micrographic Surgery |
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/ |
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 |
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 |
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.