MR. RAJENDRA GAVINI (NPI# 1053501973) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053501973 |
| Entity Type | Individual |
| Full Name | MR. RAJENDRA GAVINI |
| Credential | M.D. |
| Practice Address |
12101 Woodcrest Executive Dr Suite 210 Saint Louis MO 63141-5047 |
| Practice Telephone | 3143170600 |
| Practice Fax Number | 3143170606 |
| Mailing Telephone | 3143170600 |
| Mailing Fax Number | 3143170606 |
| Enumeration Date | 2007-07-26 |
| Last Update Date | 2014-04-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | R6940 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 1053501973 | 05 |
| Street Address |
12101 WOODCREST EXECUTIVE DR SUITE 210 |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63141-5047 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285630160 | Novamed Eye Surgery Center of North County, LLC | Clinic/Center | 12101 Woodcrest Executive Dr, Suite 101, Saint Louis, MO 63141-5047 | 2005-06-24 |
| 1326497587 | Ipc Pac Healthcare Services of Missouri Inc | Psychologist | 12101 Woodcrest Executive Dr, Suite 210, Saint Louis, MO 63141-5047 | 2016-06-08 |
| 1003260100 | Novamed Eye Surgery Center of North County LLC | Nurse Anesthetist, Certified Registered | 12101 Woodcrest Executive Dr, Suite 101, Saint Louis, MO 63141-5047 | 2016-04-15 |
| 1982071262 | Davina Angelene Dupree | Nurse Practitioner | 12101 Woodcrest Executive Dr, Suite 210, Saint Louis, MO 63141-5047 | 2015-08-21 |
| 1215328174 | Colleen Elizabeth Tepen | Nurse Practitioner | 12101 Woodcrest Executive Dr, Suite 210, Saint Louis, MO 63141-5047 | 2015-02-13 |
| 1902107725 | Latoya Demetrist Lane | Nurse Practitioner | 12101 Woodcrest Executive Dr, Suite 210, Saint Louis, MO 63141-5047 | 2010-11-10 |
| 1588739858 | Olive Ambulatory Surgery Center, LLC | Clinic/Center | 12101 Woodcrest Executive Dr, Ste 101, Saint Louis, MO 63141-5047 | 2006-11-22 |
| 1952325789 | Gopal K Nair | Internal Medicine | 12101 Woodcrest Executive Dr, Suite 210, Saint Louis, MO 63141-5047 | 2006-07-26 |
| 1629022918 | In Home Health LLC | Hospice Care, Community Based | 12101 Woodcrest Executive Dr, Suite 102, Saint Louis, MO 63141-5047 | 2006-05-20 |
| 1053364992 | In Home Health LLC | Home Health | 12101 Woodcrest Executive Dr, Saint Louis, MO 63141-5047 | 2006-05-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679102842 | Noor Ramadan | Pharmacist | 628 North New Ballad Road, Suite A, Creve Coeur, MO 63141 | 2020-04-08 |
| 1497381206 | Washington University | Durable Medical Equipment & Medical Supplies | 1044 North Mason Road, Suite 110/210, St. Louis, MO 63141 | 2020-03-13 |
| 1154956498 | Ashleigh Clendenny | Physician Assistant | Mercy Hospital St. Louis, 615 S New Ballas Rd, St. Louis, MO 63141 | 2020-03-06 |
| 1801429410 | Emili Lou Haley | Registered Nurse | 650 Maryville Drive, St Louis, MO 63141 | 2020-02-21 |
| 1629553110 | Rebecca Kathleen Pike | Social Worker | West County Psychological Associates, 12125 Woodcrest Executive Drive #110, St. Louis, MO 63141 | 2018-10-01 |
| 1649756099 | River City Sedation Associates, LLC | Nurse Anesthetist, Certified Registered | 12855 N 40 Dr Ste 150, Saint Louis, MO 63141 | 2018-07-18 |
| 1205333952 | Ear Care and Hearing of St. Louis | Hearing Aid Equipment | 11630 Studt Ave Ste 210, Creve Coeur, MO 63141 | 2018-04-10 |
| 1659897486 | Erin Goodman | Physical Therapist | 10560 Old Olive St. Rd, Suite 100, Creve Coeur, MO 63141 | 2017-08-14 |
| 1093230450 | Center for Urologic Surgery LLC | Clinic/Center | 12855 N 40 Dr Ste 100, Saint Louis, MO 63141 | 2017-08-07 |
| 1871016105 | Jacob Farley Tanner | Specialist/Technologist | 1054 Town and Four Parkway Dr, Creve Coeur, MO 63141 | 2017-07-19 |
| Find all providers in zip 63141 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790205854 | Zachary Avital Goodman | General Practice | 6642 Clayton Rd # 278, Saint Louis, MO 63117-1602 | 2017-06-20 |
| 1174926224 | Anita Dewan | General Practice | 9917 Grandview Forest Ct, Saint Louis, MO 63127-0046 | 2014-10-03 |
| 1356755201 | Jessica Ellie Ma | General Practice | 216 S Kingshighway Blvd Fl 6, 6th Floor, Saint Louis, MO 63110-1026 | 2014-06-19 |
| 1235550385 | Doctor's On The Way, Inc | General Practice | 712 N 2nd St, Ste 310, Saint Louis, MO 63102-2550 | 2013-12-16 |
| 1518398916 | John Allen Cooper | General Practice | 40 N Kingshighway Blvd Apt 13f, Saint Louis, MO 63108-1343 | 2013-12-10 |
| 1417382821 | Hyung T Kim | General Practice | 11 Crestwood Dr, Saint Louis, MO 63105-3032 | 2013-09-05 |
| 1356617443 | Kirsten Frances Dunn | General Practice | 1040 N Mason Rd Ste 103, Ste 103, Saint Louis, MO 63141-6361 | 2012-03-22 |
| 1902199623 | Care Plus Medical Group LLC | General Practice | 10650 Gateway Blvd, Saint Louis, MO 63132-1802 | 2011-05-27 |
| 1437474202 | Debra Lynne Moss | General Practice | 12929 Ballantine Ct, Saint Louis, MO 63146-3701 | 2010-04-05 |
| 1558538850 | Patrice Lynn Wakefield | General Practice | 514 Donne Ave, Saint Louis, MO 63130-3918 | 2008-05-15 |
| Find all providers in SAINT LOUIS | ||||
| City | SAINT LOUIS |
| Zip Code | 63141 |
Please comment or provide details below to improve the information on MR. RAJENDRA GAVINI.
| 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.