SPECIALIST IN AGING SUCCESSFULLY LLC (NPI# 1023572690) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023572690 |
| Entity Type | Organization |
| Organization Name | SPECIALIST IN AGING SUCCESSFULLY LLC |
| Practice Address |
12255 De Paul Dr Ste 260 Bridgeton MO 63044-2510 |
| Mailing Address |
Po Box 8356 Saint Louis MO 63132-0356 |
| Practice Telephone | 3142095100 |
| Mailing Telephone | 3142095100 |
| Enumeration Date | 2019-01-28 |
| Last Update Date | 2019-02-14 |
| Authorized Official Name | DR. ASIF BHUTTO (MEMBER) |
| Authorized Official Telephone | 3142095100 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RG0300X |
Internal Medicine Specialization: Geriatric Medicine |
Allopathic & Osteopathic Physicians |
| Street Address |
12255 DE PAUL DR STE 260 |
| City | BRIDGETON |
| State | MO |
| Zip Code | 63044-2510 |
| 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 | 207RG0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Geriatric Medicine |
| An internist who has special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes and the hospital. |
| 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 |
|---|---|---|---|---|
| 1164037875 | Visiting Physicians LLC | Internal Medicine | 108 E Green Meadows Rd Ste 3, Columbia, MO 65203-3633 | 2020-09-10 |
| 1023592946 | Institute of Medicine LLC | Internal Medicine | 6824 Balson Ave, Saint Louis, MO 63143-2603 | 2018-09-17 |
| 1104235241 | Generation Clinical Partners LLC | Internal Medicine | 11500 Olive Blvd Ste 235, Saint Louis, MO 63141-7141 | 2014-08-02 |
| 1477967883 | Medical Directors of The Ozarks LLC | Internal Medicine | 302 Veterans Blvd, Branson, MO 65616-2091 | 2014-06-13 |
| 1306133012 | Karen Markeisha Sobers | Internal Medicine | 901 Patients First Dr Ste 3881, Washington, MO 63090-4700 | 2011-07-01 |
| 1285881912 | Gopal K Nair, Md, PC | Internal Medicine | 1023 Arlington Oaks Ter, Chesterfield, MO 63017-5936 | 2008-08-25 |
| 1154577799 | Stanley Sharp Md Lc | Internal Medicine | 1310 Carondelet Dr Ste 230, Kansas City, MO 64114-4853 | 2008-08-14 |
| 1558563890 | Hassan Dawoud Elsiddig | Internal Medicine | 3660 Vista Ave # 204, Saint Louis, MO 63110-2540 | 2007-05-31 |
| 1871795104 | Shehla Sadiq | Internal Medicine | 3660 Vista Ave # 2104, Saint Louis, MO 63110-2540 | 2007-05-31 |
| 1265634513 | Vijaya Nattuvetty Vasudevan | Internal Medicine | 5600 Mexico Rd Ste 21, Saint Peters, MO 63376-1660 | 2007-05-31 |
| Find all providers with the same taxonomy | ||||
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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.