ST LOUIS UNIVERSITY (NPI# 1306120183) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306120183 |
| Entity Type | Organization |
| Organization Name | ST LOUIS UNIVERSITY |
| Other Organization Name | SLUCARE DEPT OF FCM SPORTS MEDICINE |
| Practice Address |
1755 S Grand Blvd Saint Louis MO 63104-1540 |
| Mailing Address |
3691 Rutger St Saint Louis MO 63110-2515 |
| Practice Telephone | 3142563850 |
| Mailing Telephone | 3149776828 |
| Enumeration Date | 2011-09-28 |
| Last Update Date | 2011-09-28 |
| Authorized Official Name | ALYCE LANXON (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 3149776828 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QS0010X |
Family Medicine Specialization: Sports Medicine |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| SLUCare Dept of FCM Sports Medicine | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487869863 | St Louis University | Eyewear Supplier (Equipment, not the service) | 1755 South Grand, St Louis, MO 63104 | 2007-05-11 |
| 1194892463 | St Louis University | Orthopaedic Surgery | 1831 Chestnut St Ste 650, Saint Louis, MO 63103 | 2006-11-29 |
| 1093894842 | St Louis University | Internal Medicine | 10 Franklin, Washington, MO 63090 | 2006-11-03 |
| 1417035759 | St Louis University | Audiologist | 3750 Lindell, St Louis, MO 63108 | 2006-11-02 |
| 1992778237 | St Louis University | Urology | 3655 Vista Ave, Saint Louis, MO 63110-2539 | 2006-02-08 |
| 1164495412 | St Louis University | Pathology | 1402 South Grand, St Louis, MO 63104 | 2006-02-08 |
| 1801869136 | St Louis University | Psychiatry & Neurology | 1438 S Grand Blvd, Saint Louis, MO 63104-1027 | 2006-02-08 |
| 1740253095 | St Louis University | Dermatology | 1755 S Grand Blvd, Saint Louis, MO 63104-1540 | 2006-02-08 |
| 1184266413 | St Louis University | Pediatrics | 1465 S Grand Blvd, Saint Louis, MO 63104-1003 | 2019-10-08 |
| 1184908865 | St Louis University | Urology | 1465 S Grand Blvd, Saint Louis, MO 63104-1003 | 2011-09-29 |
| Street Address |
1755 S GRAND BLVD |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63104-1540 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740253095 | St Louis University | Dermatology | 1755 S Grand Blvd, Saint Louis, MO 63104-1540 | 2006-02-08 |
| 1295363372 | Jordan Benjamin Leynes | Physician Assistant | 1755 S Grand Blvd, Saint Louis, MO 63104-1540 | 2020-04-01 |
| 1366936411 | Gabriela Madeleine Morris | Internal Medicine | 1755 S Grand Blvd, Saint Louis, MO 63104 | 2018-06-20 |
| 1891228425 | Madelyn Farrell Oliver Jeter | Student in an Organized Health Care Education/Training Program | 1755 S Grand Blvd, Saint Louis, MO 63104-1540 | 2017-04-10 |
| 1982079810 | Claudia Sophia Morr Verenzuela | Dermatology | 1755 S Grand Blvd, Saint Louis, MO 63104-1540 | 2015-12-03 |
| 1528447125 | Kristin Colleen Smith | Dermatology | 1755 S Grand Blvd, Saint Louis, MO 63104-1540 | 2015-05-28 |
| 1205213253 | Ashley Mcwilliams | Student in an Organized Health Care Education/Training Program | 1755 S Grand Blvd, Saint Louis, MO 63104-1540 | 2015-04-29 |
| 1154714202 | Heidi Elaine Roeder | Physician Assistant | 1755 S Grand Blvd, Saint Louis, MO 63104-1540 | 2015-03-13 |
| 1134534811 | Jennifer Albus Fehlman | Dermatology | 1755 S Grand Blvd, Saint Louis, MO 63104-1540 | 2014-06-21 |
| 1124446588 | Saniya Shaikh | Student in an Organized Health Care Education/Training Program | 1755 S Grand Blvd, Saint Louis, MO 63104-1540 | 2014-04-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407469570 | Family Care Health Centers | Clinic/Center | 2717 Sidney Street, St. Louis, MO 63104 | 2020-08-28 |
| 1023638038 | Laura Ann Humphrey | Physician Assistant | Allied Health Building 3437 Caroline Street, Room 3015, Saint Louis, MO 63104 | 2020-04-20 |
| 1174187264 | Ahsan Ali | Student in an Organized Health Care Education/Training Program | 1438 South Grand Blvd, Monteleone Hall, St. Louis, MO 63104 | 2019-04-24 |
| 1205359916 | Brenda Eve Ladin | Behavior Technician | 1221 Allen Market Lane Rear, St. Louis, MO 63104 | 2017-07-25 |
| 1841722063 | Gustavo G Mendez | Student in an Organized Health Care Education/Training Program | 1465 South Grand Bulevard Rm 2717, Ssm Health Cardinal Glennon Children's Hospital, Saint Louis, MO 63104 | 2017-03-28 |
| 1053776716 | Carmella Harper | Respiratory Therapist, Certified | 2678 Park Ave, St Louis, MO 63104 | 2015-12-23 |
| 1922485986 | Alexander Tremont | Internal Medicine | 1402 S Grand Blvd Rm M260, Saint Louis, MO 63104 | 2015-04-29 |
| 1306233341 | Healthcare R Us | Home Health | 2859 Sidney St, St Louis, MO 63104 | 2015-04-16 |
| 1396159091 | Daniela Hermelin | Pathology | 1402 South Grane, St. Louis, MO 63104 | 2014-06-20 |
| 1992117881 | Kelly Denise Durbin | Social Worker | 1920 S 7th St, Saint Louis, MO 63104 | 2014-05-27 |
| Find all providers in zip 63104 | ||||
| Taxonomy Code | 207QS0010X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Sports Medicine |
| A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation. |
| 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 Family Medicine, 2007. http://www.theabfm.org/. American Osteopathic Board of Family Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871115857 | Ben Heimos | Family Medicine | 1 S Compton Ave, Saint Louis, MO 63103-2001 | 2020-05-12 |
| 1063568640 | Christian Verry | Family Medicine | 12680 Olive Blvd Ste 300, Saint Louis, MO 63141-6322 | 2007-01-26 |
| 1548867963 | Elizabeth Savika Liotta | Family Medicine | 916 Olive St, Saint Louis, MO 63101-1400 | 2020-10-08 |
| 1750872354 | Iconic Services Inc | Family Medicine | 4625 Lindell Blvd Ste 200, Saint Louis, MO 63108-3729 | 2018-05-21 |
| 1780948018 | St.. Louis University | Family Medicine | 1755 S Grand Blvd, Saint Louis, MO 63104-1540 | 2012-07-02 |
| 1619238235 | St. Anthony's Physician Organization | Family Medicine | 2900 Lemay Ferry Rd, Suite 104, Saint Louis, MO 63125-3900 | 2012-05-30 |
| 1376778076 | Ha Minh Hoang | Family Medicine | 3635 Vista Ave, 7th Floor Desloge Towers, Saint Louis, MO 63110-2539 | 2009-05-26 |
| 1497958508 | William A. Mitchell IIi | Family Medicine | 1755 S Grand Blvd, Anheuser Busch Institute - Dept. of Orthopedics, Saint Louis, MO 63104-1540 | 2007-06-06 |
| 1295839702 | Kirkwood Diagnostic & Orthopedic Associates, LLC. | Family Medicine | 333 S Kirkwood Rd, Suite 203, Saint Louis, MO 63122-6161 | 2006-09-13 |
| 1578672341 | Steven Stahle | Family Medicine | 333 S Kirkwood Rd, Suite 103, Saint Louis, MO 63122-6161 | 2006-08-29 |
| Find all providers in SAINT LOUIS | ||||
| City | SAINT LOUIS |
| Zip Code | 63104 |
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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.