AESTHETIC DERMATOLOGIC SURGERY (NPI# 1982897450) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982897450 |
| Entity Type | Organization |
| Organization Name | AESTHETIC DERMATOLOGIC SURGERY |
| Practice Address |
9717 Landmark Parkway Dr Suite 115 Saint Louis MO 63127-1628 |
| Mailing Address |
Po Box 270686 Saint Louis MO 63127-0686 |
| Practice Telephone | 3148497546 |
| Practice Fax Number | 3148497558 |
| Mailing Telephone | 3148497546 |
| Mailing Fax Number | 3148497558 |
| Enumeration Date | 2007-08-19 |
| Last Update Date | 2009-08-27 |
| Authorized Official Name | DR. ERIN SCOTT GARDNER (PHYSICIAN/OWNER) |
| Authorized Official Telephone | 3148497546 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207N00000X | Dermatology | 2001005039 | MO | Allopathic & Osteopathic Physicians |
| N | 207ND0900X |
Dermatology Specialization: Dermatopathology |
2001005039 | MO | Allopathic & Osteopathic Physicians |
| N | 207NP0225X |
Dermatology Specialization: Pediatric Dermatology |
2001005039 | MO | Allopathic & Osteopathic Physicians |
| N | 207NS0135X |
Dermatology Specialization: Procedural Dermatology |
2001005039 | MO | Allopathic & Osteopathic Physicians |
| Y | 207ND0101X |
Dermatology Specialization: MOHS-Micrographic Surgery |
2001005039 | MO | Allopathic & Osteopathic Physicians |
| Street Address |
9717 LANDMARK PARKWAY DR SUITE 115 |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63127-1628 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285630061 | Erin Scott Gardner | Dermatology | 9717 Landmark Parkway Dr, Ste 115, Saint Louis, MO 63127-1628 | 2005-06-25 |
| 1801430442 | Sophai Thach | Nurse Practitioner | 9717 Landmark Parkway Dr, Saint Louis, MO 63127-1628 | 2019-11-06 |
| 1588110480 | Derek Christopher Braddix | Nurse Practitioner | 9717 Landmark Parkway Dr, Saint Louis, MO 63127-1628 | 2016-08-30 |
| 1609242619 | The Health & Wellness Center for Men, LLC | Nurse Practitioner | 9717 Landmark Parkway Dr, Suite 115, Saint Louis, MO 63127-1628 | 2015-08-13 |
| 1568796514 | Victoria Dean Pannett | Counselor | 9717 Landmark Parkway Dr, Suite 208, Saint Louis, MO 63127-1628 | 2009-09-23 |
| 1750599841 | Mary Jo Anne Wagner | Physical Therapist | 9717 Landmark Parkway Dr, #216, Saint Louis, MO 63127-1628 | 2007-05-20 |
| 1740405547 | Thomas E Gaegiula, D.c., P.C. | Chiropractor | 9717 Landmark Parkway Dr, Suite 216, Saint Louis, MO 63127-1628 | 2007-04-16 |
| 1720101215 | Shawn P. Reiter D.c.p.c. | Chiropractor | 9717 Landmark Parkway Dr, Suite 216, Saint Louis, MO 63127-1628 | 2007-04-09 |
| 1457487100 | Shawn Reiter | Chiropractor | 9717 Landmark Parkway Dr, 216, Saint Louis, MO 63127-1628 | 2007-02-26 |
| 1215072640 | Thomas Edward Gargiula | Chiropractor | 9717 Landmark Parkway Dr, Suite 216, Saint Louis, MO 63127-1628 | 2007-02-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730698374 | Advanced Surgical Center of Sunset Hills LLC | Clinic/Center | 4594 S Lindbergh Blvd, Saint Louis, MO 63127 | 2017-09-27 |
| 1811382179 | Robert Paul Hintze | Dentist | 3555 Sunset Office Dr Ste 210, Saint Louis, MO 63127 | 2015-04-03 |
| 1639560782 | Bwell Pharmacy LLC | Pharmacy | 12128 Gravois Road, St.louis, MO 63127 | 2015-02-11 |
| 1043612773 | Braham Dev Dewan | Internal Medicine | 9917 Grandview Forest Court, Saint Louis, MO 63127 | 2014-09-25 |
| 1639518673 | Jonathan Yoon | Otolaryngology | 9701 Landmark Parkway Dr Ste 201, Saint Louis, MO 63127 | 2013-06-24 |
| 1639515315 | Kathleen Mary Lowe | Internal Medicine | 3844 S Lindbergh Blvd Ste 120, Saint Louis, MO 63127 | 2013-05-21 |
| 1366782088 | Sunset Hills Family Chiropractic LLC | Clinic/Center | 4600 South Lindbergh Ave, Suite 3, St. Louis, MO 63127 | 2013-02-15 |
| 1063743300 | John Ralph Firth | Dentist | 3890 So. Lindbergh Blvd., Suite 115, Sunset Hills, MO 63127 | 2010-01-27 |
| 1174762850 | Antonio I Longrais | Dentist | 4600 S. Lindbeigh 63127, St. Louis, MO 63127 | 2009-02-19 |
| 1447439716 | George D Bankhead Dds Ms PC | Dentist | 3890 S Lindbergh Blvd, Suite 115, Sunset Hills, MO 63127 | 2007-11-02 |
| Find all providers in zip 63127 | ||||
| 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 |
| 1962624585 | St Louis University | Dermatology | 1755 S Grand Blvd, Saint Louis, MO 63104-1540 | 2007-05-03 |
| 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 |
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| City | SAINT LOUIS |
| Zip Code | 63127 |
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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.