VASCULAR SURGERY OF ST. LOUIS P.C. (NPI# 1316128846) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316128846 |
| Entity Type | Organization |
| Organization Name | VASCULAR SURGERY OF ST. LOUIS P.C. |
| Practice Address |
2355 Dougherty Ferry Rd Suite 440 Saint Louis MO 63122-3325 |
| Practice Telephone | 3146148775 |
| Practice Fax Number | 3149839559 |
| Mailing Telephone | 3146148775 |
| Mailing Fax Number | 3149839559 |
| Enumeration Date | 2007-11-27 |
| Last Update Date | 2009-04-17 |
| Authorized Official Name | MS. ANGELA RENEE CHAMBERLIN (MANAGER) |
| Authorized Official Telephone | 3147500935 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
R7H29 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 202643524 | 05 |
| Street Address |
2355 DOUGHERTY FERRY RD SUITE 440 |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63122-3325 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043296494 | Darin Marshall Minkin | Surgery | 2355 Dougherty Ferry Rd, 430, Saint Louis, MO 63122 | 2005-12-19 |
| 1083163570 | Michael Jeffries | Physician Assistant | 2355 Dougherty Ferry Rd, Suite #330, Saint Louis, MO 63122-3325 | 2016-09-26 |
| 1649642349 | Lisa Ann Hunt | Nurse Practitioner | 2355 Dougherty Ferry Rd, Saint Louis, MO 63122-3325 | 2015-10-21 |
| 1346650884 | Matthew T. Ricks Do LLC | Surgery | 2355 Dougherty Ferry Rd, 430, Saint Louis, MO 63122-3325 | 2014-05-06 |
| 1255597738 | Darin M Minkin Inc | Surgery | 2355 Dougherty Ferry Rd, Ste 430, Saint Louis, MO 63122-3356 | 2008-08-04 |
| 1780846196 | Mary Jo Beason | Audiologist | 2355 Dougherty Ferry Rd, Suite 430, Saint Louis, MO 63122-3325 | 2008-06-26 |
| 1780857532 | Sharon Marie Prusaczyk | Audiologist | 2355 Dougherty Ferry Rd, Saint Louis, MO 63122-3325 | 2008-04-11 |
| 1932226107 | Advanced Urology Associates, LLC | Urology | 2355 Dougherty Ferry Rd, Suite 410, Saint Louis, MO 63122-3325 | 2007-03-23 |
| 1598823478 | West County Family Medicine, Inc | Family Medicine | 2355 Dougherty Ferry Rd, Ste 320, Saint Louis, MO 63122-3325 | 2006-12-05 |
| 1336216902 | Des Peres Medical Specialist | General Acute Care Hospital | 2355 Dougherty Ferry Rd, Suite 408, Saint Louis, MO 63122-3325 | 2006-11-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659933174 | Keela Rushing | Physical Therapist | 439 S Kirkwood Rd Ste 200, Kirkwood, MO 63122 | 2019-07-04 |
| 1730643461 | Kirkwood Family Dental | Dentist | 333 S Kirkwood Road, Suite 105, Kirkwood, MO 63122 | 2019-01-28 |
| 1477061166 | Total Access Urgent Care, PC | Clinic/Center | 2980 Dougherty Ferry Rd, Saint Louis, MO 63122 | 2018-01-16 |
| 1760933469 | Missouri Cvs Pharmacy, L.l.c | Durable Medical Equipment & Medical Supplies | 10820 Manchester Rd, Kirkwood, MO 63122 | 2016-10-18 |
| 1518321041 | M. Kathleen Blanchard | Counselor | 11042 Manchester Rd., Kirkwood, MO 63122 | 2016-04-11 |
| 1265801914 | Kim Grega | Counselor | 700 S Kirkwood Rd, Kirkwood, MO 63122 | 2015-09-23 |
| 1245617943 | Mark Edward Taylor | Dentist | 610 North Geyer, Kirkwood, MO 63122 | 2015-05-01 |
| 1467843094 | Mary Elizabeth Boomgarden | Physical Therapist | 9645 Big Bend Boulevard, Saint Louis, MO 63122 | 2015-02-18 |
| 1760725717 | Michael Diller Counseling | Counselor | 144 W Madison Avenue, Kirkwood, MO 63122 | 2013-03-28 |
| 1427309954 | Anne Marie Delaplain | Dentist | 725 Laclede Station Road, Webster Groves, MO 63122 | 2012-09-24 |
| Find all providers in zip 63122 | ||||
| Taxonomy Code | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376801548 | Matthew Raymond Abate | Surgery | 10012 Kennerly Rd Ste 305, Saint Louis, MO 63128-2197 | 2012-04-25 |
| 1518992429 | Ayaz A Malik | Surgery | 1035 Bellevue Ave Ste 212, Saint Louis, MO 63117-1846 | 2006-07-11 |
| 1083687859 | Vidal T Sheen | Surgery | 11144 Tesson Ferry Rd, Suite 100, Saint Louis, MO 63123-6965 | 2006-02-10 |
| 1770145401 | Brian Patrick Sullivan | Surgery | 1 Barnes Jewish Hospital Plz, Saint Louis, MO 63110-1003 | 2019-07-02 |
| 1467947382 | Momodou L Jammeh | Surgery | 1 Barnes Jewish Hospital Plz, Saint Louis, MO 63110 | 2018-06-22 |
| 1861912529 | Katherine Marie Holzem | Surgery | 1 Barnes Jewish Hospital Plz, Saint Louis, MO 63110-1003 | 2017-06-23 |
| 1922458892 | Bradley John Bowles | Surgery | 3635 Vista At Grand Boulevard, Saint Louis, MO 63110-4271 | 2016-06-21 |
| 1962852178 | Brandon D Downing | Surgery | 660 S Euclid Ave, Campus Box 8109, 5103a Queeny Tower, Saint Louis, MO 63110-1010 | 2016-06-18 |
| 1093078115 | John Westley Ohman | Surgery | 1 Barnes Jewish Hospital Plz, Saint Louis, MO 63110-1003 | 2012-06-22 |
| 1093946873 | Suaiman Syed Shoab | Surgery | 3655 Vista Ave, Saint Louis, MO 63110-2539 | 2009-07-28 |
| Find all providers in SAINT LOUIS | ||||
| City | SAINT LOUIS |
| Zip Code | 63122 |
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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.