ST LOUIS UNIVERSITY (NPI# 1023220910) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1023220910 |
Entity Type | Organization |
Organization Name | ST LOUIS UNIVERSITY |
Other Organization Name | SLUCARE DEPT OF OTOLARYNGOLOGY-FACIAL PLASTIC SURGERY |
Practice Address |
3660 Vista Ave Saint Louis MO 63110-2540 |
Mailing Address |
1831 Chestnut St Ste 650 Saint Louis MO 63103-2236 |
Practice Telephone | 3149775110 |
Mailing Telephone | 3149776828 |
Enumeration Date | 2007-05-04 |
Last Update Date | 2019-06-21 |
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 | 207YS0123X |
Otolaryngology Specialization: Facial Plastic Surgery |
Allopathic & Osteopathic Physicians |
Other Name | Type Code |
---|---|
SLUCARE DEPT OF OTOLARYNGOLOGY-FACIAL PLASTIC 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 |
3660 VISTA AVE |
City | SAINT LOUIS |
State | MO |
Zip Code | 63110-2540 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1871582692 | Alan P K Wild | Otolaryngology | 3660 Vista Ave, Ste. 312, Saint Louis, MO 63110 | 2005-10-14 |
1922627207 | Emily Bayliss Worrall | Student in an Organized Health Care Education/Training Program | 3660 Vista Ave, Saint Louis, MO 63110-2540 | 2020-04-16 |
1508485988 | Jackson Jeffrey Meland | Student in an Organized Health Care Education/Training Program | 3660 Vista Ave, Saint Louis, MO 63110-2540 | 2020-04-15 |
1316566748 | Katherine Elizabeth Oberhelman | Student in an Organized Health Care Education/Training Program | 3660 Vista Ave, Saint Louis, MO 63110-2540 | 2020-04-15 |
1063031664 | Elizabeth Jane De Quetteville Robin | Student in an Organized Health Care Education/Training Program | 3660 Vista Ave, Saint Louis, MO 63110-2540 | 2020-04-14 |
1053930586 | Tim Brotherton Jr. | Student in an Organized Health Care Education/Training Program | 3660 Vista Ave, Saint Louis, MO 63110-2540 | 2020-04-14 |
1285253328 | Eugene Chiemeka Nwankwo Jr. | Student in an Organized Health Care Education/Training Program | 3660 Vista Ave, Saint Louis, MO 63110-2540 | 2020-04-09 |
1124647318 | Christian Hendrix | Student in an Organized Health Care Education/Training Program | 3660 Vista Ave, Saint Louis, MO 63110-2540 | 2020-04-08 |
1851920730 | Kellen J Smutz | Student in an Organized Health Care Education/Training Program | 3660 Vista Ave, Saint Louis, MO 63110-2540 | 2020-04-03 |
1487283172 | Abhinav Reddy | Student in an Organized Health Care Education/Training Program | 3660 Vista Ave, Saint Louis, MO 63110-2540 | 2020-04-03 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1659971992 | Carrie Ellen Smith | Nurse Practitioner | Mailstop 90-00-174, One Barnes-jewish Plaza, St. Louis, MO 63110 | 2020-10-27 |
1881210466 | Michelle Amanda Freilich | Internal Medicine | Barnes-jewish Plaza, St. Louis, MO 63110 | 2020-06-19 |
1245856046 | Jeevin Shahi | Radiology | 3685 Vista Avenue, Center for Radiation Medicine, St. Louis, MO 63110 | 2020-06-18 |
1497371314 | Wilson Eduardo Rodriguez | Student in an Organized Health Care Education/Training Program | 1008 S. Spring, St Louis, MO 63110 | 2020-06-17 |
1578184065 | Kathryn Kay Lindsay | Registered Nurse | Saint Louis University Dept of Surgery, 3635 Vista Ave 3dt, St Louis, MO 63110 | 2020-05-06 |
1881232700 | Ashley Diane Pace | Nurse Practitioner | 1 Parkview Place, Shoenberg 6900, St. Louis, MO 63110 | 2019-12-11 |
1619520418 | Krithika Damodar Shenoy | Pathology | 660 Euclid Avenue, One Barnes Jewish Hospital Plaza, St. Louis, MO 63110 | 2019-07-20 |
1467912550 | Ian Ferguson | Dermatology | 660 S Euclid Ave., Cb 8123, St. Louis, MO 63110 | 2019-03-23 |
1760978688 | Ihab Hassanieh | Student in an Organized Health Care Education/Training Program | 33660 Vista Ave, St. Louis, MO 63110 | 2018-07-03 |
1336634500 | Martin K Mwangi | Pediatrics | 1 Childrens Place, 3s34, St. Louis, M, MO 63110 | 2018-06-28 |
Find all providers in zip 63110 |
Taxonomy Code | 207YS0123X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Otolaryngology |
Specialization | Facial Plastic Surgery |
An otolaryngologist who specializes in facial plastic surgery. |
Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate was, but is no longer issued by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1730170507 | Frank Simo | Otolaryngology | 10448 Old Olive Street Rd Ste 200, Saint Louis, MO 63141-5927 | 2005-11-02 |
1265436711 | Robert Daniel Craig | Otolaryngology | 777 S New Ballas Rd, Ste 320e, Saint Louis, MO 63141-8789 | 2005-06-10 |
1598892838 | William H Friedman | Otolaryngology | 3023 N Ballas Rd, Suite 600d, Saint Louis, MO 63131-2330 | 2007-02-27 |
1396810982 | Nayak Plastic Surgery, P.C. | Otolaryngology | 607 S Lindbergh Blvd, Saint Louis, MO 63131-2734 | 2006-11-21 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1619057064 | Justin W. Roberts | Otolaryngology | 501 West Pine Street, Farmington, MO 63640 | 2006-10-17 |
1215938550 | Anthony Joseph D'angelo Jr. | Otolaryngology | 2315 Dougherty Ferry Road, Suite 103, St. Louis, MO 63122 | 2005-08-09 |
1154520757 | Nathan Seth Box | Otolaryngology | 1331 W 32nd St, Joplin, MO 64804-1601 | 2007-07-13 |
1609925809 | Tamara Kay Ehlert | Otolaryngology | 522 N New Ballas Rd, Suite 300, Creve Coeur, MO 63141-6857 | 2007-01-09 |
1104911288 | Ear Nose & Throat & Plastic Surg Inc | Otolaryngology | 2315 Dougherty Ferry Road, Ste. 103, St. Louis, MO 63122 | 2006-10-04 |
1205825031 | Richard W Maack | Otolaryngology | 226 S Woods Mill Rd, Suite 37 West, Chesterfield, MO 63017-3662 | 2005-10-14 |
1386645463 | Richard Lee Barnes | Otolaryngology | 2315 Dougherty Ferry Road, Ste. 103, St. Louis, MO 63122 | 2005-08-10 |
City | SAINT LOUIS |
Zip Code | 63110 |
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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.