William F Sudholt (NPI# 1164486254, PAC ID# 1759305378) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is INTERNAL MEDICINE.
| Nation Provider ID (NPI) | 1164486254 |
| PAC ID by PECOS | 1759305378 |
| Professional Enrollment ID | I20060124000100 |
| Full Name | William F Sudholt |
| Organization Legal Name | IPC PAC HEALTHCARE SERVICES OF MISSOURI INC |
| Address |
4005 Ripa Ave Saint Louis MO 63125-2378 |
| Phone Number | 3145441111 |
| Gender | M |
| Credential | DO |
| Graduation Year | 2002 |
| Primary Specialty | INTERNAL MEDICINE |
| Secondary Specialties | HOSPITALIST |
| Group Practice PAC ID | 4587950589 |
| Number of Group Practice Members | 14 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 260193 | ST MARYS MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 19600 E 39th St, Centerpoint Medical Center, Independence, MO 64057-2301 | 8166987000 | INPATIENT CONSULTANTS OF KANSAS PA |
| 4005 Ripa Ave, Saint Louis, MO 63125-2378 | 3145441111 | IPC PAC HEALTHCARE SERVICES OF MISSOURI INC |
| Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
|---|---|---|---|
| MIPS_EC_130_overall | Documentation of Current Medications in the Medical Record | 100% |
| Organization Legal Name | IPC PAC HEALTHCARE SERVICES OF MISSOURI INC |
| Physicians | 15 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Zackary D Coco | Nurse Practitioner | Ipc Pac Healthcare Services of Missouri Inc | 101 Cynthia St, Judsonia, AR 72081-9766 |
| Syreeta Van Ross | Nurse Practitioner | Ipc Pac Healthcare Services of Missouri Inc | 4005 Ripa Ave, Saint Louis, MO 63125-2378 |
| Jei Martin | Internal Medicine | Ipc Pac Healthcare Services of Missouri Inc | 5400 Executive Centre Pkwy, Villages of St Peters Mo, Saint Peters, MO 63376-2594 |
| Rajendra Rao Gavini | General Practice | Ipc Pac Healthcare Services of Missouri Inc | 5303 Bermuda Dr, Saint Louis, MO 63121-1407 |
| Shobha L Dixit | Internal Medicine | Ipc Pac Healthcare Services of Missouri Inc | 322 Old State Rd, Ellisville, MO 63021-5917 |
| Gopal K Nair | Internal Medicine | Ipc Pac Healthcare Services of Missouri Inc | 35 Sugar Maple Ln, Saint Charles, MO 63303-5740 |
| Tiffany L Nelson | Nurse Practitioner | Ipc Pac Healthcare Services of Missouri Inc | 4005 Ripa Ave, Saint Louis, MO 63125-2378 |
| Cierra Nicole Dillard | Nurse Practitioner | Ipc Pac Healthcare Services of Missouri Inc | 4005 Ripa Ave, Saint Louis, MO 63125-2378 |
| Gina Iheonu Uzendu | Nurse Practitioner | Ipc Pac Healthcare Services of Missouri Inc | 1200 Graham Rd, Florissant, MO 63031-8015 |
| James L Paulsgrove | Internal Medicine | Ipc Pac Healthcare Services of Missouri Inc | 4005 Ripa Ave, Saint Louis, MO 63125-2378 |
| Street Address |
4005 RIPA AVE |
| City | SAINT LOUIS |
| State | MO |
| Zip | 63125-2378 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Syreeta Van Ross | Nurse Practitioner | Ipc Pac Healthcare Services of Missouri Inc | 4005 Ripa Ave, Saint Louis, MO 63125-2378 |
| Tiffany L Nelson | Nurse Practitioner | Ipc Pac Healthcare Services of Missouri Inc | 4005 Ripa Ave, Saint Louis, MO 63125-2378 |
| Cierra Nicole Dillard | Nurse Practitioner | Ipc Pac Healthcare Services of Missouri Inc | 4005 Ripa Ave, Saint Louis, MO 63125-2378 |
| James L Paulsgrove | Internal Medicine | Ipc Pac Healthcare Services of Missouri Inc | 4005 Ripa Ave, Saint Louis, MO 63125-2378 |
| Heejin Kwon | Nurse Practitioner | Ipc Pac Healthcare Services of Missouri Inc | 4005 Ripa Ave, Saint Louis, MO 63125-2378 |
| Ray A Bartlett | Physician Assistant | Ipc Pac Healthcare Services of Missouri Inc | 4005 Ripa Ave, Saint Louis, MO 63125-2378 |
| Andrea E Ivy | Nurse Practitioner | Ipc Pac Healthcare Services of Missouri Inc | 4005 Ripa Ave, Saint Louis, MO 63125-2378 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Edward A Hengel | Chiropractic | 4006 Bayless Ave, Saint Louis, MO 63125-1314 | |
| Brook C Raye | Nurse Practitioner | Institute for Research and Education In Family Medicine | 9417 S Broadway, Saint Louis, MO 63125-2009 |
| Marta R Gray | Nurse Practitioner | Institute for Research and Education In Family Medicine | 9417 S Broadway, Saint Louis, MO 63125-2009 |
| David C Campbell | Family Medicine | Institute for Research and Education In Family Medicine | 9417 S Broadway, Saint Louis, MO 63125-2009 |
| Stacy L Lobello | Nurse Practitioner | Institute for Research and Education In Family Medicine | 9417 S Broadway, Saint Louis, MO 63125-2009 |
| Chontay L Mckay | Nurse Practitioner | Institute for Research and Education In Family Medicine | 9417 S Broadway, Saint Louis, MO 63125-2009 |
| Kenya S Shotwell | Nurse Practitioner | Institute for Research and Education In Family Medicine | 9417 S Broadway, Saint Louis, MO 63125-2009 |
| Russell R Kraeger | General Surgery | 1400 Lemay Ferry Rd, Saint Louis, MO 63125-2417 | |
| Richard A Money | Clinical Social Worker | 1204 Telegraph Rd, St Louis, MO 63125-2528 | |
| William L Herbold | Optometry | Clarkson Optometry Inc | 2572 Lemay Ferry Rd, Saint Louis, MO 63125-3131 |
| Find all physicians in zip 63125 | |||
| City | SAINT LOUIS |
| Zip Code | 63125 |
| Specialty | INTERNAL MEDICINE |
| City + Specialty | SAINT LOUIS + INTERNAL MEDICINE |
Please comment or provide details below to improve the information on William F Sudholt.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.