DR. BRENTON HENRY PENNICOOKE


Address: 517 S Euclid Ave, Saint Louis, MO 63110-1007
Phone: 3143623577

DR. BRENTON HENRY PENNICOOKE (NPI# 1093093064) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1093093064
Entity Type Individual
Full Name DR. BRENTON HENRY PENNICOOKE
Credential MD, MS
Practice Address 517 S Euclid Ave
Saint Louis
MO 63110-1007
Mailing Address 660 South Euclid Ave
Campus Box 8057
St. Louis
MO 63110-3901
Practice Telephone 3143623577
Practice Fax Number 3143622107
Mailing Telephone 3147476145
Mailing Fax Number 3143622107
Enumeration Date 2011-07-25
Last Update Date 2020-09-17
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 207T00000X Neurological Surgery 160390 CA Allopathic & Osteopathic Physicians
N 207T00000X Neurological Surgery 288251 NY Allopathic & Osteopathic Physicians
Y 207T00000X Neurological Surgery 2020021408 MO Allopathic & Osteopathic Physicians
N 207XS0117X Orthopaedic Surgery
Specialization: Orthopaedic Surgery of the Spine
2020021408 MO Allopathic & Osteopathic Physicians

Provider Secondary Practice Location

Address Telephone Number Fax Number
12634 Olive Blvd, Saint Louis, MO 631416337 3143623577

Office Location

Street Address 517 S EUCLID AVE
City SAINT LOUIS
State MO
Zip Code 63110-1007

Providers in the same location

NPI Name Taxonomy Address Enumeration
1871596890 Robert M Feibel Ophthalmology 517 S Euclid Ave, Saint Louis, MO 63110-1007 2005-05-23
1053856963 Tiffany Christina Ho Ophthalmology 517 S Euclid Ave, 1st Fl, Dept Opthalmology, Saint Louis, MO 63110-1007 2016-12-31
1578914974 Alexander Steven Barsam Ophthalmology 517 S Euclid Ave, 1st Fl, Dept Opthalmology, Saint Louis, MO 63110-1007 2016-06-27
1093165490 Maxwell William Dixon Ophthalmology 517 S Euclid Ave, 1st Fl, Dept Opthalmology, Saint Louis, MO 63110-1007 2016-06-16
1518314350 Eric Landis Sollenberger Ophthalmology 517 S Euclid Ave, 1st Fl, Dept Opthalmology, Saint Louis, MO 63110-1007 2016-05-23
1972957975 Kishan Girish Patel Ophthalmology 517 S Euclid Ave, 1st Fl, Dept Opthalmology, Saint Louis, MO 63110-1007 2016-04-16
1497119093 Khin Pyaesone Kilgore Ophthalmology 517 S Euclid Ave, 1st Fl, Dept Opthalmology, Saint Louis, MO 63110-1007 2016-04-09
1639533722 Jason Nicholas Papas Ophthalmology 517 S Euclid Ave, 1st Fl, Dept Opthalmology, Saint Louis, MO 63110-1007 2016-04-05
1427439298 Bliss Elizabeth O'bryhim Ophthalmology 517 S Euclid Ave, Saint Louis, MO 63110-1007 2015-06-17
1093101974 James Chang Liu Ophthalmology 517 S Euclid Ave, Saint Louis, MO 63110-1007 2015-04-08
Find all providers in the same location

Providers in the same zip code

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 Information

Taxonomy Code 207T00000X
Grouping Allopathic & Osteopathic Physicians
Classification Neurological Surgery

Taxonomy Definition

A neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify function or activity of the nervous system; and the operative and non-operative management of pain. A neurological surgeon treats patients with disorders of the nervous system; disorders of the brain, meninges, skull, and their blood supply, including the extracranial carotid and vertebral arteries; disorders of the pituitary gland; disorders of the spinal cord, meninges, and vertebral column, including those which may require treatment by spinal fusion or instrumentation; and disorders of the cranial and spinal nerves throughout their distribution.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Neurological Surgery, 2007. http://www.abns.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Neurological Surgery.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1912276486 Paul Edward Stohr Neurological Surgery 2 Kirken Knoll Dr, Saint Louis, MO 63131-2310 2011-12-29
1275801896 George Emanuel Mendelsohn Neurological Surgery 24 Loren Woods, Saint Louis, MO 63124-1903 2011-12-09
1770802076 Aneela Darbar Neurological Surgery 3635 Vista Ave, Grand Blvd, Saint Louis, MO 63110-0250 2010-05-26
1386850881 David D Limbrick Jr. Neurological Surgery 1 Childrens Pl Ste 4e, Ste 4e, Saint Louis, MO 63110-1002 2007-05-14
1376560805 Tae Sung Park Neurological Surgery 1 Childrens Pl Fl 1, 1st Fl, Saint Louis, MO 63110-1002 2006-07-17
1841218278 Matthew D Smyth Neurological Surgery 1 Childrens Pl Ste 4s20, Ste 4s20, Saint Louis, MO 63110-1002 2006-07-17
1265420269 Robert J Bernardi IIi Neurological Surgery 11605 Studt Ave, Suite One, Saint Louis, MO 63141-7052 2005-10-12
1457351926 Gregory Joseph Bailey Neurological Surgery 1035 Bellevue Ave Ste 500, Saint Louis, MO 63117-1843 2005-07-27
1326048935 Charles A Wetherington Neurological Surgery 6725 Chippewa St, Saint Louis, MO 63109-2534 2005-07-26
1306846928 Armond L Levy Neurological Surgery 13625 Big Bend Rd, Saint Louis, MO 63122-3915 2005-07-26
Find all providers in SAINT LOUIS

Competitor

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City SAINT LOUIS
Zip Code 63110

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Dataset Information

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.

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