DR. BROOKE I POLK (NPI# 1235490400) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235490400 |
| Entity Type | Individual |
| Full Name | DR. BROOKE I POLK |
| Credential | MD |
| Practice Address |
1 Childrens Pl Ste C Ste C Saint Louis MO 63110-1002 |
| Mailing Address |
660 S Euclid Ave C B 8116 Saint Louis MO 63110-1010 |
| Practice Telephone | 3144542694 |
| Practice Fax Number | 3144542515 |
| Mailing Telephone | 3144542694 |
| Mailing Fax Number | 3144542515 |
| Enumeration Date | 2012-06-05 |
| Last Update Date | 2018-01-29 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208000000X | Pediatrics | 2015014464 | MO | Allopathic & Osteopathic Physicians |
| Y | 2080P0201X |
Pediatrics Specialization: Pediatric Allergy/Immunology |
2015014464 | MO | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407178155 | Brooke Polk | Speech-Language Pathologist | 1912 Sparrowridge Cir, Haughton, LA 71037-7714 | 2010-02-23 |
| 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 |
| 1972879088 | Michael David Thompson | Pediatrics | 1 Childrens Pl Ste C, Ste C, Saint Louis, MO 63110-1002 | 2012-03-23 |
| 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 | 2080P0201X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Allergy/Immunology |
| A pediatrician who specializes in the diagnosis and treatment of allergies, allergic reactions, and immunologic diseases in children. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: title modified, definition added, source added] Additional Resources: A Certification of Special Qualifications (CSQ) is issued by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649499401 | St Louis University | Pediatrics | 1465 S Grand Blvd, Saint Louis, MO 63104-1003 | 2007-04-24 |
| 1619993920 | Gordon R Bloomberg | Pediatrics | 1 Childrens Pl, Ste 5s30, Saint Louis, MO 63110-1002 | 2006-07-14 |
| 1821037334 | Ray S Davis | Pediatrics | 1 Childrens Pl, Saint Louis, MO 63110-1002 | 2006-06-06 |
| 1578510509 | Lisa V Suffian | Pediatrics | 1 Childrens Pl, Saint Louis, MO 63110-1002 | 2006-05-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275828717 | Michael Ian Derrick | Pediatrics | 2401 Gillham Rd, Kansas City, MO 64108-4619 | 2011-06-13 |
| 1073561742 | Paul Joseph Dowling Jr. | Pediatrics | 2401 Gillham Rd, Kansas City, MO 64108-4619 | 2006-05-05 |
| 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.