KEELY L COOK (NPI# 1225154743) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225154743 |
| Entity Type | Individual |
| Full Name | KEELY L COOK |
| Credential | PA |
| Practice Address |
12855 N 40 Dr Suite 175 Saint Louis MO 63141-8635 |
| Mailing Address |
Po Box 2147 Fort Myers FL 33902-2147 |
| Practice Telephone | 3146289000 |
| Practice Fax Number | 3146289696 |
| Mailing Telephone | 2394241600 |
| Mailing Fax Number | 2394241640 |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2020-08-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
085-000551 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 100264100 | 05 | |
| IL | STATE LICENSE | 085-000551 | 01 |
| Street Address |
12855 N 40 DR SUITE 175 |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63141-8635 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942206354 | St. Louis Pharmaceutical Services LLC | Pharmacy | 12855 N 40 Dr, Saint Louis, MO 63141-8635 | 2005-06-22 |
| 1700423076 | Faisal Matar | Nurse Practitioner | 12855 N 40 Dr, Saint Louis, MO 63141-8622 | 2019-12-05 |
| 1750847984 | Samantha Mintert | Nurse Practitioner | 12855 N 40 Dr, Saint Louis, MO 63141-8622 | 2019-02-12 |
| 1629439302 | Elizabeth Galler | Physician Assistant | 12855 N 40 Dr, 180, Saint Louis, MO 63141-8657 | 2016-03-09 |
| 1992161210 | Amy Thayer | Nurse Practitioner | 12855 N 40 Dr, Suite 180, Saint Louis, MO 63141-8657 | 2016-01-04 |
| 1821453796 | Mason Ridge Ambulatory Surgery Center Lp | Clinic/Center | 12855 N 40 Dr, Suite 150, Saint Louis, MO 63141-8657 | 2015-12-21 |
| 1083090088 | Rebecca Suzanne Roe Thomasson | Physician Assistant | 12855 N 40 Dr, Suite 180, Saint Louis, MO 63141-8657 | 2015-08-03 |
| 1891179040 | Forefront Dermatology, S.c. | Dermatology | 12855 N 40 Dr, Suite 180, Saint Louis, MO 63141 | 2015-07-17 |
| 1669869657 | Christopher Joseph Forsbach | Podiatrist | 12855 N 40 Dr, Saint Louis, MO 63141 | 2015-04-17 |
| 1346633930 | Chesterfield Anesthesia Associates of Missouri, LLC | Anesthesiology | 12855 N 40 Dr, 150, Saint Louis, MO 63141-8657 | 2015-03-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679102842 | Noor Ramadan | Pharmacist | 628 North New Ballad Road, Suite A, Creve Coeur, MO 63141 | 2020-04-08 |
| 1497381206 | Washington University | Durable Medical Equipment & Medical Supplies | 1044 North Mason Road, Suite 110/210, St. Louis, MO 63141 | 2020-03-13 |
| 1154956498 | Ashleigh Clendenny | Physician Assistant | Mercy Hospital St. Louis, 615 S New Ballas Rd, St. Louis, MO 63141 | 2020-03-06 |
| 1801429410 | Emili Lou Haley | Registered Nurse | 650 Maryville Drive, St Louis, MO 63141 | 2020-02-21 |
| 1629553110 | Rebecca Kathleen Pike | Social Worker | West County Psychological Associates, 12125 Woodcrest Executive Drive #110, St. Louis, MO 63141 | 2018-10-01 |
| 1649756099 | River City Sedation Associates, LLC | Nurse Anesthetist, Certified Registered | 12855 N 40 Dr Ste 150, Saint Louis, MO 63141 | 2018-07-18 |
| 1205333952 | Ear Care and Hearing of St. Louis | Hearing Aid Equipment | 11630 Studt Ave Ste 210, Creve Coeur, MO 63141 | 2018-04-10 |
| 1659897486 | Erin Goodman | Physical Therapist | 10560 Old Olive St. Rd, Suite 100, Creve Coeur, MO 63141 | 2017-08-14 |
| 1093230450 | Center for Urologic Surgery LLC | Clinic/Center | 12855 N 40 Dr Ste 100, Saint Louis, MO 63141 | 2017-08-07 |
| 1871016105 | Jacob Farley Tanner | Specialist/Technologist | 1054 Town and Four Parkway Dr, Creve Coeur, MO 63141 | 2017-07-19 |
| Find all providers in zip 63141 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891227393 | Hollis Smith | Physician Assistant | 2015 Maplewood Commons Dr, Saint Louis, MO 63143-1003 | 2017-04-03 |
| 1649397894 | Rachel S Tarr | Physician Assistant | 2208 Richert Pl, Saint Louis, MO 63143-2522 | 2007-03-23 |
| 1528198439 | Jonathan Adam Pellechia | Physician Assistant | 11155 Dunn Rd Ste 315e, Saint Louis, MO 63136-6111 | 2007-03-07 |
| 1376174417 | Robert Cory Proffer | Physician Assistant | 607 S New Ballas Rd Ste 2300, Saint Louis, MO 63141-8234 | 2020-01-28 |
| 1881246502 | Ariel Ashley Schnell | Physician Assistant | 3655 Vista Ave, Saint Louis, MO 63110-2539 | 2019-07-12 |
| 1194296186 | Jacob Bast | Physician Assistant | 10010 Kennerly Rd, Saint Louis, MO 63128-2106 | 2018-12-17 |
| 1508335779 | Gerard Forster | Physician Assistant | 12647 Olive Blvd Ste 600, Saint Louis, MO 63141-6346 | 2018-11-17 |
| 1124509773 | Sara Burke Connolly | Physician Assistant | 1 Barnes Jewish Hospital Plz, Saint Louis, MO 63110-1003 | 2018-08-22 |
| 1831675545 | Kyle Patrick Mclafferty | Physician Assistant | 11133 Dunn Rd, Saint Louis, MO 63136-6163 | 2018-07-16 |
| 1649768995 | Paul Thomas Mrotek | Physician Assistant | 1 Barnes Jewish Hospital Plz, Saint Louis, MO 63110-1003 | 2018-04-23 |
| Find all providers in SAINT LOUIS | ||||
| City | SAINT LOUIS |
| Zip Code | 63141 |
Please comment or provide details below to improve the information on KEELY L COOK.
| 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.