AFFTON MEDICAL CLINIC (NPI# 1114048154) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114048154 |
| Entity Type | Organization |
| Organization Name | AFFTON MEDICAL CLINIC |
| Practice Address |
59 Grasso Plz Saint Louis MO 63123-3107 |
| Practice Telephone | 3146389309 |
| Practice Fax Number | 3146389333 |
| Mailing Telephone | 3146389309 |
| Mailing Fax Number | 3146389333 |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2008-06-16 |
| Authorized Official Name | DR. RUBILINDA GIMENA CASINO (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 3146389309 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080A0000X |
Pediatrics Specialization: Adolescent Medicine |
R5P40 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 205357908 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528251337 | Affton Medical Clinic | Internal Medicine | 84 Grasso Plaza, St Louis, MO 63123 | 2007-08-24 |
| Street Address |
59 GRASSO PLZ |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63123-3107 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770002610 | Peter Brown | Home Health Aide | 9530 Antigo Dr, St Louis, MO 63123 | 2017-09-12 |
| 1346629748 | Emily Murray | Community/Behavioral Health | 7556 Genesta Street, Saint Louis, MO 63123 | 2015-05-19 |
| 1730566183 | Family Home & Health Care Services | Home Health | 9124 Lemona Drive, Saint Louis, MO 63123 | 2015-05-05 |
| 1114319092 | Kathi Wallace | Counselor | 11166 Tesson Ferry Rd., Suite #203 Alpha Omega Christian Counseling, St. Louis, MO 63123 | 2015-03-02 |
| 1982981098 | Robert Arthur Bilzing | Pharmacist | 9949 Tesson Ferry Rd, St. Louis, MO 63123 | 2011-11-03 |
| 1760767198 | Valentina Jovic | Pharmacist | 5764 South Lindbergh Blvd, St. Louis, MO 63123 | 2011-10-17 |
| 1033423504 | Margaret L Shields Inc | Podiatrist | 11132 South Towne Square, Ste 105, St Louis, MO 63123 | 2010-07-27 |
| 1083858336 | John David Bouhasin | Pediatrics | 7629 Bracken Circle, St. Louis, MO 63123 | 2009-04-29 |
| 1326288929 | Erica J Fahrner | Occupational Therapist | 6022 S. Lindbergh, Suite 100, Saint Louis, MO 63123 | 2009-02-23 |
| 1629248158 | Maria Ramona Eppler | Nurse Practitioner | 4217 Bayless Ave., St. Louis, MO 63123 | 2008-03-12 |
| Find all providers in zip 63123 | ||||
| Taxonomy Code | 2080A0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Adolescent Medicine |
| A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932328796 | St Louis University | Pediatrics | 1465 S Grand Blvd, Saint Louis, MO 63104-1003 | 2007-04-24 |
| 1760556708 | Ariane E May | Pediatrics | 4055 Lindell Blvd, Saint Louis, MO 63108-3201 | 2006-11-20 |
| 1518030097 | Jill M. Baer | Pediatrics | 3009 N Ballas Rd, Suite 257-c, Saint Louis, MO 63131-2322 | 2006-11-15 |
| 1801999768 | Joyce D Johnson | Pediatrics | 6744 Clayton Rd, Saint Louis, MO 63117-1637 | 2006-09-06 |
| 1730295759 | Joseph Prusaczyk | Pediatrics | 13035 Olive Blvd, Saint Louis, MO 63141-6173 | 2006-08-22 |
| 1649292780 | Sarah Ann Tycast | Pediatrics | 1 Childrens Pl, Saint Louis, MO 63110-1002 | 2006-07-25 |
| 1528081544 | Lynn K White | Pediatrics | 1 Childrens Pl, Saint Louis, MO 63110-1002 | 2006-07-25 |
| 1023036746 | Maryjo Hernandez-zipfel | Pediatrics | 4055 Lindell Blvd, Saint Louis, MO 63108-3201 | 2006-07-18 |
| 1750310439 | Amal F Antoun | Pediatrics | 1717 Biddle St, Saint Louis, MO 63106-3454 | 2006-07-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366670796 | Fernando Fernandez, M. D. PC | Pediatrics | 2750 Clay Edwards Dr Ste 320, North Kansas City, MO 64116-3259 | 2009-06-24 |
| 1073733069 | Kelly Jo Meier | Pediatrics | 2719 E 32nd St, Joplin, MO 64804-3131 | 2007-05-01 |
| 1851417794 | Shari L Smith | Pediatrics | 200 Castle Drive, Joplin, MO 64804-9115 | 2007-03-22 |
| 1811076763 | Nedra Diann Twillie | Pediatrics | 415 Burkarth Rd Ste D, Warrensburg, MO 64093-3101 | 2006-11-03 |
| 1740209162 | Nancy Elizabeth Holmes | Pediatrics | 8888 Ladue Road, Suite 130, St. Louis, MO 63124 | 2006-07-18 |
| 1194770883 | Ann A Gassman | Pediatrics | 503 N Scott Ave, Belton, MO 64012-1730 | 2006-05-23 |
| 1841299161 | Bryson Roy Mchardy Jr. | Pediatrics | 100 Medical Dr, Hannibal, MO 63401-6877 | 2005-07-19 |
| 1245239797 | Jeffrey Paul Yannette | Pediatrics | 821 Sw Lemans Lane, Lees Summit, MO 64082 | 2005-07-18 |
| 1679570618 | Carolyn Ann Ellsworth | Pediatrics | 312 N Kentucky St, West Plains, MO 65775-2073 | 2005-07-06 |
| 1528064102 | Joseph William Stafford Jr. | Pediatrics | 312 N Kentucky Ave, West Plains, MO 65775-2073 | 2005-06-28 |
| Find all providers with the same taxonomy | ||||
| City | SAINT LOUIS |
| Zip Code | 63123 |
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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.