TRACY L SMITH (NPI# 1255895496) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255895496 |
| Entity Type | Individual |
| Full Name | TRACY L SMITH |
| Credential | AGNP |
| Practice Address |
10012 Kennerly Rd Ste 404 Saint Louis MO 63128-2197 |
| Practice Telephone | 3145435911 |
| Practice Fax Number | 3145435914 |
| Mailing Telephone | 3145435911 |
| Mailing Fax Number | 3145435914 |
| Enumeration Date | 2019-01-22 |
| Last Update Date | 2019-09-03 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
201900944 | MO | Allopathic & Osteopathic Physicians |
| N | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
2019000944 | MO | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629681036 | Tracy Smith | In Home Supportive Care | 2400 Buffalo Gap Rd # 189, Abilene, TX 79605-6102 | 2020-08-25 |
| 1881236552 | Tracy Smith | Contractor | 1619 3rd Ave Se, Rochester, MN 55904-7945 | 2019-10-14 |
| 1619534013 | Tracy Erica Smith | Technician, Other | 1202 Glenview Dr, Mogadore, OH 44260-9581 | 2019-05-22 |
| 1346709011 | Tracy Cornelia Smith | Nurse Practitioner | 6104 Raleigh St Apt 1606, Orlando, FL 32835-2230 | 2019-03-13 |
| 1588135750 | Tracy Jo Smith | Voluntary or Charitable | 4259 N Williamston Rd, Williamston, MI 48895-9175 | 2018-12-16 |
| 1194222372 | Tracy Lynette Smith | Counselor | 55 Seargent Dr, Natchez, MS 39120-4782 | 2018-04-12 |
| 1740728070 | Tracy Smith | Social Worker | 8507 Ne 47th Street, Spencer, OK 73084 | 2017-02-07 |
| 1194273425 | Tracy Smith | Social Worker | 40 Daveitta Dr, Savannah, GA 31419-3155 | 2016-09-15 |
| 1265810410 | Tracy Dawn Smith | Counselor | 400 Bhrett Dr, Energy, IL 62933-3570 | 2015-05-08 |
| 1457789356 | Tracy L Smith | Behavioral Analyst | 10917 N Blackwelder Ave, Oklahoma City, OK 73120-7915 | 2013-10-31 |
| Street Address |
10012 KENNERLY RD STE 404 |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63128-2197 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982648259 | Samer Alkaade | Internal Medicine | 10012 Kennerly Rd Ste 404, Saint Louis, MO 63128 | 2006-06-16 |
| 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 | 207RG0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Gastroenterology |
| An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal 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 |
|---|---|---|---|---|
| 1215359484 | Advanced Gastroenterology & Colon Cancer Screening Center LLC | Internal Medicine | 763 S New Ballas Rd # 265, Saint Louis, MO 63141-8704 | 2014-01-07 |
| 1689014276 | Antonio Ricardo Cheesman Rocca | Internal Medicine | 1225 S Grand Blvd Fl 3, Saint Louis, MO 63104-1016 | 2013-06-27 |
| 1720346729 | Kayci Renee Huff-hardy | Internal Medicine | 621 S New Ballas Rd Ste 437a, Saint Louis, MO 63141-8259 | 2012-04-26 |
| 1750676664 | Parul Gor | Internal Medicine | 615 S New Ballas Rd Ste 1200, Saint Louis, MO 63141 | 2011-06-20 |
| 1902034499 | Giao Vuong | Internal Medicine | 6400 Clayton Rd Ste 216, Saint Louis, MO 63117-1850 | 2009-06-23 |
| 1790908820 | Kishore Maganty | Internal Medicine | 522 N New Ballas Rd Ste 210, Saint Louis, MO 63141-6829 | 2007-04-10 |
| 1043309792 | Robert M Mcmahon | Internal Medicine | 1610 Des Peres Rd Ste 150, Saint Louis, MO 63131-1863 | 2006-10-12 |
| 1154418119 | Hugo A Villarreal | Internal Medicine | 13276 Manchester Rd, Saint Louis, MO 63131-1706 | 2006-10-09 |
| 1952494932 | Muhammad A. Nyazee | Internal Medicine | 11155 Dunn Rd Ste 212e, Saint Louis, MO 63136-6166 | 2006-10-02 |
| 1487745360 | David J Costigan | Internal Medicine | 10007 Kennerly Rd, Saint Louis, MO 63128-2179 | 2006-09-27 |
| Find all providers in SAINT LOUIS | ||||
| City | SAINT LOUIS |
| Zip Code | 63128 |
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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.