DR. CHARLES M SAMSON (NPI# 1194932301) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194932301 |
| Entity Type | Individual |
| Full Name | DR. CHARLES M SAMSON |
| Credential | MD |
| Practice Address |
1 Childrens Pl Ste C Ste C Saint Louis MO 63110-1002 |
| Mailing Address |
1 Childrens Pl Nwt 8328 Cb 8116 Saint Louis MO 63110-1002 |
| Practice Telephone | 3144546173 |
| Practice Fax Number | 3144542412 |
| Mailing Telephone | 3144546173 |
| Mailing Fax Number | 3144542412 |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2018-01-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208000000X | Pediatrics | 2011019875 | MO | Allopathic & Osteopathic Physicians |
| Y | 2080P0206X |
Pediatrics Specialization: Pediatric Gastroenterology |
2011019875 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | ENROLLED | 05 | |
| MO | 1194932301 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871639443 | Charles Edward Samson | Chiropractor | 755 Grattan St, Chicopee, MA 01020-1238 | 2007-01-30 |
| Street Address |
1 CHILDRENS PL STE C STE C |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63110-1002 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164428389 | Tasnim A Najaf | Pediatrics | 1 Childrens Pl Ste C, Ste C, Saint Louis, MO 63110-1002 | 2005-06-22 |
| 1942712278 | Claire Elizabeth Seper | Nurse Practitioner | 1 Childrens Pl Ste C, Ste C, Saint Louis, MO 63110-1002 | 2017-10-26 |
| 1801333018 | Elizabeth Rose Toolan | Dietitian, Registered | 1 Childrens Pl Ste C, Ste C, Saint Louis, MO 63110-1002 | 2017-01-25 |
| 1184161820 | Linda Piersall Manwaring | Genetic Counselor, MS | 1 Childrens Pl Ste C, Ste C, Saint Louis, MO 63110-1002 | 2017-01-19 |
| 1891231544 | Marisa Vineyard Andrews | Genetic Counselor, MS | 1 Childrens Pl Ste C, Ste C, Saint Louis, MO 63110-1002 | 2017-01-18 |
| 1467998112 | Elise Marguerite Fiala | Genetic Counselor, MS | 1 Childrens Pl Ste C, Ste C, Saint Louis, MO 63110-1002 | 2017-01-18 |
| 1487019394 | Ericka Lauren Louer | Nurse Practitioner | 1 Childrens Pl Ste C, Ste C, Saint Louis, MO 63110-1002 | 2015-12-18 |
| 1588043632 | Diana Lynn Culbertson | Pediatrics | 1 Childrens Pl Ste C, Ste C, Saint Louis, MO 63110-1002 | 2015-05-21 |
| 1790106391 | Andrea Nicole Herkenhoff | Nurse Practitioner | 1 Childrens Pl Ste C, Ste C, Saint Louis, MO 63110-1002 | 2013-12-27 |
| 1235490400 | Brooke I Polk | Pediatrics | 1 Childrens Pl Ste C, Ste C, Saint Louis, MO 63110-1002 | 2012-06-05 |
| Find all providers in the same location | ||||
| 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 Code | 2080P0206X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Gastroenterology |
| A pediatrician who specializes in the diagnosis and treatment of diseases of the digestive systems of infants, children and adolescents. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using lighted scopes to see internal organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366920118 | Danielle Marie Kenner | Pediatrics | 615 S New Ballas Rd Ste Yg230, Saint Louis, MO 63141-8221 | 2018-08-03 |
| 1467747659 | Fernando Rafael Medina Carbonell | Pediatrics | 1465 S Grand Blvd, Saint Louis, MO 63104-1003 | 2011-06-15 |
| 1689986382 | Rachel Kassel | Pediatrics | 1 Childrens Pl # 3s34, Saint Louis, MO 63110-1002 | 2010-07-09 |
| 1033352885 | Mercy Clinic Kids Gi, LLC | Pediatrics | 621 S New Ballas Rd, Suite 140-a, Saint Louis, MO 63141-8232 | 2009-04-09 |
| 1508085382 | St Louis University | Pediatrics | 1465 S Grand Blvd, Saint Louis, MO 63104-1003 | 2007-04-24 |
| 1215954771 | Ross William Shepherd | Pediatrics | 1 Childrens Pl, Saint Louis, MO 63110-1002 | 2006-07-17 |
| 1528086048 | Phillip Irwin Tarr | Pediatrics | 1 Childrens Pl, Saint Louis, MO 63110-1002 | 2006-07-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003383258 | Jose J. Derdoy, Md, LLC | Pediatrics | 845 N New Ballas Ct Ste 330, Creve Coeur, MO 63141-7169 | 2018-10-25 |
| 1679699060 | Children's Gastroenterology of St. Louis, P.C. | Pediatrics | 224 S Woods Mill Rd Ste 640, Chesterfield, MO 63017-3451 | 2007-03-21 |
| 1366550261 | Jose Lorenzo Tirol Cocjin | Pediatrics | 2401 Gilham Rd Children's Mercy Hospitals and Clinic, Pediatric Gastroenterology, Kansas City, MO 64108 | 2006-08-29 |
| 1952361081 | David Richard Fleisher | Pediatrics | University of Missouri School of Medicine, Dept of Child Health. 1 Hospital Drive, Columbia, MO 65212 | 2006-03-24 |
| 1235510900 | Panamdeep Kaur | Pediatrics | 2401 Gillham Rd, Kansas City, MO 64108 | 2015-06-17 |
| 1194089557 | Roopali Mittal | Pediatrics | 404 N Keene St, Columbia, MO 65201 | 2012-06-30 |
| 1255622452 | Nadia Ibrahimi | Pediatrics | 2401 Gillham Rd, Kansas City, MO 64108-4619 | 2011-04-22 |
| 1356652606 | Abhishek Watts | Pediatrics | 1965 S Fremont Ave, Suite 220, Springfield, MO 65804-2201 | 2010-07-01 |
| 1346472461 | Daniel Raphael Levinson | Pediatrics | 1 Children's Place, St Louis, MO 63110-1002 | 2009-08-24 |
| 1952566994 | Valentina Shakhnovich | Pediatrics | 2401 Gillham Rd, Kansas City, MO 64108-4619 | 2008-07-18 |
| Find all providers with the same taxonomy | ||||
| City | SAINT LOUIS |
| Zip Code | 63110 |
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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.