MARY JO GORMAN (NPI# 1972576775) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972576775 |
| Entity Type | Individual |
| Full Name | MARY JO GORMAN |
| Credential | M.D. |
| Practice Address |
12303 Depaul Drive Bridgeton MO 63044-5536 |
| Mailing Address |
999 Executive Parkway Dr Suite 320 Saint Louis MO 63141-6336 |
| Practice Telephone | 3143446000 |
| Practice Fax Number | 3145146020 |
| Mailing Telephone | 3145146000 |
| Mailing Fax Number | 3145146020 |
| Enumeration Date | 2006-02-10 |
| Last Update Date | 2009-03-23 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0200X |
Internal Medicine Specialization: Critical Care Medicine |
R5G50 | MO | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861555096 | Mary Beck Gorman | Anesthesiology | 137 W Lee St, Baltimore, MD 21201-2420 | 2006-12-19 |
| 1073606828 | Mary Gorman | Physical Therapist | 309 S Pacific Hwy, Talent, OR 97540-6650 | 2006-10-02 |
| 1477663573 | Mary Sloan Gorman | Social Worker | 205 Keller St Ste 202c, Petaluma, CA 94952-2878 | 2006-08-30 |
| 1710925359 | Mary G Gorman | Emergency Medicine | 723 Hill Country Dr Ste C, Kerrville, TX 78028-6043 | 2006-06-04 |
| 1205807286 | Mary Gorman | Nurse Practitioner | 4967 Crooks Rd Ste 130, Troy, MI 48098-5812 | 2006-01-30 |
| 1316370281 | Mary Ellen Gorman | Registered Nurse | 2215 Fuller Rd, Ann Arbor, MI 48105-2303 | 2013-08-15 |
| 1790078517 | Mary Larissa Gorman | Counselor | 135 Colorado St E, Saint Paul, MN 55107-2244 | 2011-05-26 |
| 1063636041 | Mary Elizabeth Gorman | Otolaryngology | 1221 Mercantile Ln, Largo, MD 20774-5374 | 2007-04-12 |
| 1386688026 | Mary Elizabeth Gorman | Nurse Anesthetist, Certified Registered | 234 Goodman St, Cincinnati, OH 45219-2364 | 2006-06-15 |
| 1346289832 | Mary A Gorman | Nurse Practitioner | 10 Gove St, East Boston, MA 02128-1920 | 2006-06-06 |
| Street Address |
12303 DEPAUL DRIVE |
| City | BRIDGETON |
| State | MO |
| Zip Code | 63044-5536 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386642320 | Sameer Rana | Internal Medicine | 12303 Depaul Drive, Bridgeton, MO 63044 | 2005-07-13 |
| 1609481241 | Hannah Ross | Social Worker | 12303 Depaul Drive, Bridgeton, MO 63044 | 2020-09-10 |
| 1023661709 | Jessica Wild | Family Medicine | 12303 Depaul Drive, Bridgeton, MO 63044 | 2019-07-22 |
| 1699330803 | Melinda Sue Nicholes | Student in an Organized Health Care Education/Training Program | 12303 Depaul Drive, Bridgeton, MO 63044 | 2019-05-02 |
| 1124580410 | Blake Thomas Savage | Student in an Organized Health Care Education/Training Program | 12303 Depaul Drive, Bridgeton, MO 63044 | 2019-04-04 |
| 1114489986 | Shiv Mehta | Student in an Organized Health Care Education/Training Program | 12303 Depaul Drive, Bridgeton, MO 63044 | 2019-04-02 |
| 1467918128 | Joy Roberts | Social Worker | 12303 Depaul Drive, Bridgeton, MO 63044 | 2019-02-18 |
| 1376074377 | Deborah Lynn Murphy | Registered Nurse | 12303 Depaul Drive, Bridgeton, MO 63044 | 2017-03-22 |
| 1174060719 | Candice Bowman | Social Worker | 12303 Depaul Drive, Bridgeton, MO 63044 | 2017-01-20 |
| 1164878252 | Deanna Krankel | Social Worker | 12303 Depaul Drive, St. Vincent's Behavioral Heatlh Services, Bridgeton, MO 63044 | 2016-05-09 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073150017 | Zoe Marie Wadsworth | Nurse Practitioner | 12255 Depaul Dr Suite 300, Bridgeton, MO 63044 | 2019-12-10 |
| 1609412451 | Beyond Better, Best Home Health Care Services, Limited Liability Corpo | In Home Supportive Care | 3430 Mckelvey Road Ste B, Bridgeton, MO 63044 | 2019-11-26 |
| 1275189078 | Delicate Angels Home Health LLC | Home Health | 11726 St. Charles Rock Road Suite G, Bridgeton, MO 63044 | 2019-08-16 |
| 1588210082 | Nicholas Huber | Physical Therapist | 12349 Depaul Dr., Ste. 110, Bridgeton, MO 63044 | 2019-08-12 |
| 1124688858 | Michelle Bassett | Registered Nurse | 11520 St. Charles Rock Rd., Suite 106, Bridgeton, MO 63044 | 2019-06-14 |
| 1336703883 | Elena A Barrow | Nurse Practitioner | 12255 Depaul Dr, Suite 260, Bridgeton, MO 63044 | 2019-04-30 |
| 1487123105 | Laura N Steiner | Registered Nurse | Gateway Pediatrics, Ltd, 12255 Depaul Drive, Suite 460 North Medical Building, Bridgeton, MO 63044 | 2018-11-26 |
| 1205310950 | Danielle Mathis | Nurse Practitioner | 3440 Depaul Lane Suite 201, Bridgeton, MO 63044 | 2018-09-19 |
| 1588163570 | Thoughts Out Loud Counseling, LLC | Social Worker | 11520 St. Charles Rock Road Suite 101, Bridgeton, MO 63044 | 2018-02-06 |
| 1912411430 | Breanna Victoria Hayes | Counselor | 3165 Mckevley Road, Suite 200, Bridgeton, MO 63044 | 2017-11-20 |
| Find all providers in zip 63044 | ||||
| Taxonomy Code | 207RC0200X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Critical Care Medicine |
| An internist who diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386642320 | Sameer Rana | Internal Medicine | 12303 Depaul Drive, Bridgeton, MO 63044 | 2005-07-13 |
| 1013178235 | Ashfaq Ullah | Internal Medicine | 12255 De Paul Dr Ste 500, Bridgeton, MO 63044-2515 | 2008-06-19 |
| 1962591222 | Parneeta H. Bhatia | Internal Medicine | 12303 De Paul Dr, Bridgeton, MO 63044-2512 | 2006-10-12 |
| 1629096359 | Michael J Walter | Internal Medicine | 12303 Depaul Dr, Bridgeton, MO 63044 | 2006-07-18 |
| 1225001951 | Gary Behrens | Internal Medicine | 12303 De Paul Dr, Bridgeton, MO 63044-2512 | 2006-02-13 |
| 1902879794 | Kenneth Bentley | Internal Medicine | 12303 Depaul Dr, Bridgeton, MO 63304 | 2006-02-10 |
| 1407829203 | Dellice Dickhaus | Internal Medicine | 12303 Depaul Drive, Bridgeton, MO 63141 | 2006-02-10 |
| 1922071729 | Francis Ntimba | Internal Medicine | 12303 Depaul Drive, Bridgeton, MO 63044 | 2006-02-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255641684 | Ashwin Mani | Internal Medicine | 999 Executive Parkway, Ste 210, St. Louis, MO 63141 | 2010-10-19 |
| 1275845208 | Jimmy L Moss | Internal Medicine | 12634 Olive Blvd Dept Of, Saint Louis, MO 63141-6337 | 2010-07-07 |
| 1124215124 | Aravind Pothineni | Internal Medicine | 1723 Broadway Suite 205, Cape Giradeau, MO 63701 | 2007-10-03 |
| 1023202736 | Branson Pulmonology LLC | Internal Medicine | 545 Branson Landing Blvd Ste 301, Branson, MO 65616-4055 | 2007-09-05 |
| 1982618856 | Mahmoud Mohamad Ali El-sayed | Internal Medicine | 1300 Turtle Cv, Ballwin, MO 63011-4249 | 2006-07-28 |
| 1689602930 | Sohail Khan | Internal Medicine | 1111 Mcintosh Cir Ste 302, Joplin, MO 64804-3693 | 2006-06-28 |
| 1154360550 | Nikhat Salamat | Internal Medicine | 727 Craig Rd, Suite 101, Creve Coeur, MO 63141-7175 | 2006-06-04 |
| 1558309898 | John R. Carlile | Internal Medicine | 1000 E. Primrose, #200, Springfield, MO 65807-5388 | 2006-06-02 |
| 1710933825 | Adeel Pervez | Internal Medicine | 4911 S Arrowhead Dr Ste 201, Independence, MO 64055-7008 | 2006-05-26 |
| 1154389336 | Patrick B Sandiford | Internal Medicine | 201 First Executive Ave, St Peters, MO 63376-1697 | 2006-05-03 |
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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.