SOUTH COUNTY ENDOCRINOLOGY AND OBESITY MEDICINE LLC (NPI# 1144564196) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144564196 |
| Entity Type | Organization |
| Organization Name | SOUTH COUNTY ENDOCRINOLOGY AND OBESITY MEDICINE LLC |
| Practice Address |
12900 Tesson Ferry Rd Ste 101 Saint Louis MO 63128-3002 |
| Practice Telephone | 3148434848 |
| Practice Fax Number | 8665102730 |
| Mailing Telephone | 3148434848 |
| Enumeration Date | 2012-11-15 |
| Last Update Date | 2019-09-16 |
| Authorized Official Name | BHARATHI RAJU (SOLE MEMBER) |
| Authorized Official Telephone | 6362365820 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
2001005643 | MO | Ambulatory Health Care Facilities |
| Street Address |
12900 TESSON FERRY RD STE 101 |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63128-3002 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720078843 | Bharathi Raju | Internal Medicine | 12900 Tesson Ferry Rd Ste 101, Saint Louis, MO 63128-3002 | 2005-10-28 |
| 1538647508 | Hadia Jaffery | Physician Assistant | 12900 Tesson Ferry Rd Ste 101, Saint Louis, MO 63128-3002 | 2018-08-01 |
| 1881118958 | Emily Jeanne Bryson | Dietitian, Registered | 12900 Tesson Ferry Rd Ste 101, Saint Louis, MO 63128-3002 | 2017-08-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235771155 | James T Fetsch Dmd LLC | Dentist | 10004 Kennerly Rd Suite 240, Saint Louis, MO 63128 | 2019-10-11 |
| 1326504655 | Nikodem Dental Holdings | Dentist | 4337 Butler Hill Rd Suite G, St Louis Mo, MO 63128 | 2019-02-12 |
| 1932678505 | Michelle Anne Arvidson | Physical Therapy Assistant | Elite Physical Therapy, 12608 Lamplighter Square Shopping Center, St. Louis, MO 63128 | 2018-11-13 |
| 1245726710 | Kristen Rider | Nurse Practitioner | 9964 Kennerly Rd Ste D, Saint Louis, MO 63128 | 2018-07-07 |
| 1306217427 | Sophia Bednarski | Dentist | 12660 Lamplighter Square Shopping Center, St. Louis, MO 63128 | 2015-10-15 |
| 1427434224 | Darcie Burrus | Counselor | 12523 Old Tesson Rd G, St Louis, MO 63128 | 2015-08-04 |
| 1710368584 | Sara Hawatmeh | Internal Medicine | 12345 W Bend Dr Ste 304, Saint Louis, MO 63128 | 2015-06-17 |
| 1871989590 | Celia Grace Montes-kolence | Speech-Language Pathologist | 12335 W Bend Drive, Saint Louis, MO 63128 | 2015-04-09 |
| 1245629302 | Marius Antonio Evans | Dentist | 9911 Kennerly Rd., Suite G, St. Louis, MO 63128 | 2015-01-13 |
| 1801230313 | Sarah Elizabeth Walsh | Emergency Medicine | 10010 Kennerly Road, Emergency Department, St. Anthony's Medical Center, St. Louis, MO 63128 | 2013-04-26 |
| Find all providers in zip 63128 | ||||
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275014953 | Arch Pediatrics LLC | Clinic/Center | 3844 S Lindbergh Blvd Ste 216, Saint Louis, MO 63127-1369 | 2018-08-22 |
| 1174015515 | Washington University Physicians In Illinois, Inc | Clinic/Center | 4511 Forest Park Ave, Saint Louis, MO 63108-2138 | 2018-06-01 |
| 1073022000 | Fairview Heights Medical Group Sc | Clinic/Center | 670 Mason Ridge Center Dr Ste 300, Saint Louis, MO 63141-8573 | 2017-09-21 |
| 1174830640 | Washington University School of Medicine | Clinic/Center | 4921 Parkview Pl Lowr Level, Center for Advanced Medicine, Saint Louis, MO 63110-1032 | 2010-09-07 |
| 1013542877 | Washington University | Clinic/Center | 4921 Parkview Pl Ste 5a, Saint Louis, MO 63110-1032 | 2020-03-11 |
| 1760946156 | Washington University Physicians In Illinois, Inc | Clinic/Center | 660 S Euclid Ave, Saint Louis, MO 63110-1010 | 2019-01-30 |
| 1003387689 | Victus Physician Services, LLC | Clinic/Center | 12345 West Bend Drive, Suite 201, Saint Louis, MO 63128 | 2018-12-08 |
| 1356822993 | Washington University Physicians In Illinois, Inc | Clinic/Center | 660 S Euclid Ave, Saint Louis, MO 63110-1010 | 2018-08-22 |
| 1972091825 | Wuca Southwest Pediatrics LLC | Clinic/Center | 6526 Lansdowne Ave, Saint Louis, MO 63109-2654 | 2018-04-26 |
| 1669995403 | Washington University | Clinic/Center | 11125 Dunn Rd Ste 100, Saint Louis, MO 63136-6132 | 2017-07-24 |
| Find all providers in SAINT LOUIS | ||||
| City | SAINT LOUIS |
| Zip Code | 63128 |
Please comment or provide details below to improve the information on SOUTH COUNTY ENDOCRINOLOGY AND OBESITY MEDICINE LLC.
| 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.