Susan Jones (NPI# 1316458870, PAC ID# 6507118841) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1316458870 |
| PAC ID by PECOS | 6507118841 |
| Professional Enrollment ID | I20181015001294 |
| Full Name | Susan Jones |
| Organization Legal Name | IMPACT PHYSICIAN GROUP MISSOURI LLC |
| Address |
12380 De Paul Dr Bridgeton MO 63044-2511 |
| Phone Number | 3147685202 |
| Gender | F |
| Graduation Year | 2017 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 4082958574 |
| Number of Group Practice Members | 14 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 260091 | SSM HEALTH ST MARY'S HOSPITAL - ST LOUIS |
| 260081 | SSM ST CLARE HEALTH CENTER |
| Address | Phone | Organization |
|---|---|---|
| 12380 De Paul Dr, Bridgeton, MO 63044-2511 | 3147685202 | IMPACT PHYSICIAN GROUP MISSOURI LLC |
| 12380 De Paul Dr, Bridgeton, MO 63044-2511 | 3144479700 | IMPACT PHYSICIAN GROUP LLC |
| 1027 Bellevue Ave, Saint Louis, MO 63117-1851 | 3147682502 | IMPACT PHYSICIAN GROUP MISSOURI LLC |
| 1027 Bellevue Ave, Saint Louis, MO 63117-1851 | 3147685202 | IMPACT PHYSICIAN GROUP LLC |
| Organization Legal Name | IMPACT PHYSICIAN GROUP MISSOURI LLC |
| Physicians | 12 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Umesh Inderlal Gandhi | Internal Medicine | Impact Physician Group Missouri LLC | 12380 De Paul Dr, Bridgeton, MO 63044-2511 |
| Arfaa H Ali | Internal Medicine | Impact Physician Group Missouri LLC | 12380 De Paul Dr, Bridgeton, MO 63044-2511 |
| Sumera Yaqub | Internal Medicine | Impact Physician Group Missouri LLC | 12380 De Paul Dr, Bridgeton, MO 63044-2511 |
| Radhika Jaladi | Internal Medicine | Impact Physician Group Missouri LLC | 12380 De Paul Dr, Bridgeton, MO 63044-2511 |
| Lubasi Akombelwa | Nurse Practitioner | Impact Physician Group Missouri LLC | 12380 De Paul Dr, Bridgeton, MO 63044-2511 |
| Renu Teckchandani | Internal Medicine | Impact Physician Group Missouri LLC | 12380 De Paul Dr, Bridgeton, MO 63044-2511 |
| Joshua Njenga | Nurse Practitioner | Impact Physician Group Missouri LLC | 12380 De Paul Dr, Bridgeton, MO 63044-2511 |
| Brenda S Gottuso | Nurse Practitioner | Impact Physician Group Missouri LLC | 12380 De Paul Dr, Bridgeton, MO 63044-2511 |
| Lucija Sadl | Nurse Practitioner | Impact Physician Group Missouri LLC | 12380 De Paul Dr, Bridgeton, MO 63044-2511 |
| Ilir Polovina | Nurse Practitioner | Impact Physician Group Missouri LLC | 12380 De Paul Dr, Bridgeton, MO 63044-2511 |
| Street Address |
12380 DE PAUL DR |
| City | BRIDGETON |
| State | MO |
| Zip | 63044-2511 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Umesh Inderlal Gandhi | Internal Medicine | Impact Physician Group Missouri LLC | 12380 De Paul Dr, Bridgeton, MO 63044-2511 |
| Arfaa H Ali | Internal Medicine | Impact Physician Group Missouri LLC | 12380 De Paul Dr, Bridgeton, MO 63044-2511 |
| Sumera Yaqub | Internal Medicine | Impact Physician Group Missouri LLC | 12380 De Paul Dr, Bridgeton, MO 63044-2511 |
| Radhika Jaladi | Internal Medicine | Impact Physician Group Missouri LLC | 12380 De Paul Dr, Bridgeton, MO 63044-2511 |
| Lubasi Akombelwa | Nurse Practitioner | Impact Physician Group Missouri LLC | 12380 De Paul Dr, Bridgeton, MO 63044-2511 |
| Renu Teckchandani | Internal Medicine | Impact Physician Group Missouri LLC | 12380 De Paul Dr, Bridgeton, MO 63044-2511 |
| Joshua Njenga | Nurse Practitioner | Impact Physician Group Missouri LLC | 12380 De Paul Dr, Bridgeton, MO 63044-2511 |
| Brenda S Gottuso | Nurse Practitioner | Impact Physician Group Missouri LLC | 12380 De Paul Dr, Bridgeton, MO 63044-2511 |
| Lucija Sadl | Nurse Practitioner | Impact Physician Group Missouri LLC | 12380 De Paul Dr, Bridgeton, MO 63044-2511 |
| Ilir Polovina | Nurse Practitioner | Impact Physician Group Missouri LLC | 12380 De Paul Dr, Bridgeton, MO 63044-2511 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Adnan Y Siddiqui | Infectious Disease | Northwest Infectious Disease Services LLC | 12774 Boenker Ln, Bridgeton, MO 63044-2436 |
| Duong T Ho | Nurse Practitioner | Northwest Infectious Disease Services LLC | 12774 Boenker Ln, Bridgeton, MO 63044-2436 |
| Molly F Caldwell Mcmillan | Infectious Disease | Northwest Infectious Disease Services LLC | 12774 Boenker Ln, Bridgeton, MO 63044-2436 |
| Shahzad Hasan | Internal Medicine | Northwest Infectious Disease Services LLC | 12774 Boenker Ln, Bridgeton, MO 63044-2436 |
| Phillip G Zinser | Infectious Disease | Northwest Infectious Disease Services LLC | 12774 Boenker Ln, Bridgeton, MO 63044-2436 |
| Jeanalyn S Guthrie | Nurse Practitioner | Northwest Infectious Disease Services LLC | 12774 Boenker Ln, Bridgeton, MO 63044-2436 |
| Julie A Shapiro | Infectious Disease | Northwest Infectious Disease Services LLC | 12774 Boenker Ln, Bridgeton, MO 63044-2436 |
| Manpreet Kaur Budhan | Nurse Practitioner | Northwest Infectious Disease Services LLC | 12774 Boenker Ln, Bridgeton, MO 63044-2436 |
| Hassan R Jafri | Physical Therapy | 12800 Boenker Ln, Bridgeton, MO 63044-2438 | |
| Timothy R Knuuttila | Chiropractic | 12258 St Charles Rock Rd, Bridgeton, MO 63044-2501 | |
| Find all physicians in zip 63044 | |||
| City | BRIDGETON |
| Zip Code | 63044 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | BRIDGETON + NURSE PRACTITIONER |
Please comment or provide details below to improve the information on Susan Jones.
| 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.