VINCENT P. FORTUNATO (NPI# 1174508436) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174508436 |
| Entity Type | Individual |
| Full Name | VINCENT P. FORTUNATO |
| Credential | MD |
| Practice Address |
2325 Dougherty Ferry Rd Ste 104 Saint Louis MO 63122-3356 |
| Mailing Address |
10004 Kennerly Rd Suite #255a Saint Louis MO 63128-2141 |
| Practice Telephone | 1482168893 |
| Practice Fax Number | 3148211887 |
| Mailing Telephone | 3148435140 |
| Mailing Fax Number | 3148438010 |
| Enumeration Date | 2005-12-09 |
| Last Update Date | 2020-08-28 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | R1J64 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | RAILROAD MEDICARE | 110080662 | 01 |
| MO | HEALTHLINK | 173933 | 01 |
| MO | BLUE CROSS | 21532 | 01 |
| MO | AETNA | 4084340 | 01 |
| MO | CIGNA HEALTHCARE | 431650657 | 01 |
| MO | 206760100 | 05 | |
| MO | UNITED HEALTHCARE | 9499441 | 01 |
| Street Address |
2325 DOUGHERTY FERRY RD STE 104 |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63122-3356 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396735734 | Michael Joseph Reschak | Internal Medicine | 2325 Dougherty Ferry Rd Ste 104, Saint Louis, MO 63122-3356 | 2005-10-26 |
| 1417459207 | Premier Medical Physicians LLC | Family Medicine | 2325 Dougherty Ferry Rd Ste 104, Saint Louis, MO 63122-3356 | 2018-03-07 |
| 1851381206 | Michele Neudecker | Nurse Practitioner | 2325 Dougherty Ferry Rd Ste 104, Saint Louis, MO 63122-3356 | 2005-10-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659933174 | Keela Rushing | Physical Therapist | 439 S Kirkwood Rd Ste 200, Kirkwood, MO 63122 | 2019-07-04 |
| 1730643461 | Kirkwood Family Dental | Dentist | 333 S Kirkwood Road, Suite 105, Kirkwood, MO 63122 | 2019-01-28 |
| 1477061166 | Total Access Urgent Care, PC | Clinic/Center | 2980 Dougherty Ferry Rd, Saint Louis, MO 63122 | 2018-01-16 |
| 1760933469 | Missouri Cvs Pharmacy, L.l.c | Durable Medical Equipment & Medical Supplies | 10820 Manchester Rd, Kirkwood, MO 63122 | 2016-10-18 |
| 1518321041 | M. Kathleen Blanchard | Counselor | 11042 Manchester Rd., Kirkwood, MO 63122 | 2016-04-11 |
| 1265801914 | Kim Grega | Counselor | 700 S Kirkwood Rd, Kirkwood, MO 63122 | 2015-09-23 |
| 1245617943 | Mark Edward Taylor | Dentist | 610 North Geyer, Kirkwood, MO 63122 | 2015-05-01 |
| 1467843094 | Mary Elizabeth Boomgarden | Physical Therapist | 9645 Big Bend Boulevard, Saint Louis, MO 63122 | 2015-02-18 |
| 1760725717 | Michael Diller Counseling | Counselor | 144 W Madison Avenue, Kirkwood, MO 63122 | 2013-03-28 |
| 1427309954 | Anne Marie Delaplain | Dentist | 725 Laclede Station Road, Webster Groves, MO 63122 | 2012-09-24 |
| Find all providers in zip 63122 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| 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 |
|---|---|---|---|---|
| 1780223933 | Glenn C. Jacobsen | Internal Medicine | 7 Carrswold Dr, Saint Louis, MO 63105-2914 | 2020-01-04 |
| 1396305868 | Kevin Colin O'fee | Internal Medicine | 1 Barnes Jewish Hospital Plz # 90-29928, Saint Louis, MO 63110-1003 | 2019-06-17 |
| 1144740200 | Michael Slade | Internal Medicine | 660 S Euclid Ave # 8056-29, Saint Louis, MO 63110-1010 | 2017-06-20 |
| 1386171312 | Niaz Memon | Internal Medicine | 625 S New Ballas Rd Ste 7020, Saint Louis, MO 63141-8218 | 2017-05-22 |
| 1043746027 | Paul David Olivo | Internal Medicine | 639 W Polo Dr, Saint Louis, MO 63105-2635 | 2017-05-11 |
| 1649706243 | Jared Frisby | Internal Medicine | 1100 S Grand Blvd Fl 8, Saint Louis, MO 63104-1015 | 2017-05-03 |
| 1518417708 | Md At Home LLC | Internal Medicine | 6 Portland Pl, Saint Louis, MO 63108-1204 | 2016-10-11 |
| 1285087429 | Kathryn Parker | Internal Medicine | 1000 Des Peres Rd Ste 300, Saint Louis, MO 63131 | 2016-07-22 |
| 1831540863 | John Kirby Krause Jr. | Internal Medicine | 1031 Highlands Plaza Dr W, Apt 510, Saint Louis, MO 63110-1303 | 2016-06-30 |
| 1104277458 | Vedica Sharma | Internal Medicine | 10010 Kennerly Rd Ste 140, Saint Louis, MO 63128-2106 | 2016-06-28 |
| Find all providers in SAINT LOUIS | ||||
| City | SAINT LOUIS |
| Zip Code | 63122 |
Please comment or provide details below to improve the information on VINCENT P. FORTUNATO.
| 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.