DR. NIRANDON WONGSURAWAT (NPI# 1376656116) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376656116 |
| Entity Type | Individual |
| Full Name | DR. NIRANDON WONGSURAWAT |
| Credential | MD |
| Practice Address |
1015 Bowles Ave Fenton MO 63026-1530 |
| Practice Telephone | 6365668155 |
| Practice Fax Number | 3149660323 |
| Mailing Telephone | 6365668155 |
| Mailing Fax Number | 3149660323 |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2010-06-29 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RE0101X |
Internal Medicine Specialization: Endocrinology, Diabetes & Metabolism |
MD34919 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 205205701 | 05 |
| Street Address |
1015 BOWLES AVE |
| City | FENTON |
| State | MO |
| Zip Code | 63026-1530 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982687059 | Robert Brunton Smith | Emergency Medicine | 1015 Bowles Ave, Fenton, MO 63026-2394 | 2005-11-22 |
| 1235756149 | Megan Poucher | Student in an Organized Health Care Education/Training Program | 1015 Bowles Ave, Fenton, MO 63026-2394 | 2020-06-26 |
| 1598389306 | Andrew Richardson | Nurse Anesthetist, Certified Registered | 1015 Bowles Ave, Fenton, MO 63026-2394 | 2020-06-08 |
| 1538714688 | Galen Inpatient Physicians Inc. | Internal Medicine | 1015 Bowles Ave, Fenton, MO 63026-2394 | 2019-08-06 |
| 1093360414 | Cep America LLC | Emergency Medicine | 1015 Bowles Ave, Fenton, MO 63026-2394 | 2019-08-02 |
| 1427525468 | Paige Cathleen Hagen | Pharmacist | 1015 Bowles Ave, Fenton, MO 63026-2394 | 2018-10-29 |
| 1700303765 | Anne M Reeb | Dietitian, Registered | 1015 Bowles Ave, Fenton, MO 63026-2394 | 2017-08-29 |
| 1851828297 | Erin Fagan | Occupational Therapist | 1015 Bowles Ave, Fenton, MO 63026-2394 | 2017-05-16 |
| 1437681418 | Matthew Schwab | Emergency Medicine | 1015 Bowles Ave, Fenton, MO 63026-2394 | 2017-03-30 |
| 1144678285 | Wilka Yaneth Vincent | Dietitian, Registered | 1015 Bowles Ave, Fenton, MO 63026-2394 | 2016-05-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871000372 | Allison Egler | Audiologist | 1011 Bowles Ave Ste 405, Fenton, MO 63026 | 2018-01-05 |
| 1629508213 | Holly Brooks Munson | Massage Therapist | 220 Copper Mountain Dr, Fenton, MO 63026 | 2017-06-15 |
| 1073978862 | Naomi Sharon | Nurse Practitioner | 1101 Bowles Avenue, Suite G50, Fenton, MO 63026 | 2015-12-21 |
| 1871981704 | Celtic Private Care of Il & Mo, LLC | In Home Supportive Care | 1653 Larkin Williams Road, Suite 201, Fenton, MO 63026 | 2014-12-30 |
| 1356747513 | Kristina Potts | Nurse Practitioner | 774 Gravois Bluffs Blvd Ste B, Fenton, MO 63026 | 2014-11-14 |
| 1245642420 | Physicians Health Group Medical Inc | General Practice | 960 S. Highway Dr, Fenton, MO 63026 | 2014-05-22 |
| 1598047409 | Kevin Eugene Bruce | Pharmacist | 1210 Sugar Creek, Fenton, MO 63026 | 2011-09-16 |
| 1215186382 | Concentra Health Services, Inc. | Clinic/Center | 128 Matrix Commons Dr., Fenton, MO 63026 | 2008-09-15 |
| 1790954410 | Castlewood Treatment Center LLC | Community/Behavioral Health | 1855 Bowles Ave, Suite 210, Fenton, MO 63026 | 2008-02-27 |
| 1073703617 | Christina R Baeres | Dietitian, Registered | 38 Majestic Ct, Fenton, MO 63026 | 2007-07-30 |
| Find all providers in zip 63026 | ||||
| Taxonomy Code | 207RE0101X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Endocrinology, Diabetes & Metabolism |
| An internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems. |
| 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 |
|---|---|---|---|---|
| 1427090836 | Physicians Health Group, LLC | Internal Medicine | 960 S Highway Dr, Fenton, MO 63026-2023 | 2006-06-11 |
| 1336589118 | Pratibha Mary Abraham | Internal Medicine | 1011 Bowles Ave Ste 300, Fenton, MO 63026-2387 | 2013-06-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811467053 | Missouri Obesity Center,llc | Internal Medicine | 1601 E Broadway Ste 160, Columbia, MO 65201-5821 | 2018-11-30 |
| 1427468164 | Naser Eddin Munir Naser Gharaibeh | Internal Medicine | 100 Mercy Way Ste 580, Joplin, MO 64804-4524 | 2014-05-03 |
| 1306144506 | James Neal Greene | Internal Medicine | 1259 Pine Dr, Mount Vernon, MO 65712-0145 | 2011-03-11 |
| 1285944850 | Richardson Endocrine Care LLC | Internal Medicine | 2865 Netherton Drive, St Louis, MO 63136-4674 | 2010-10-18 |
| 1992019921 | Jonathan David Bortz | Internal Medicine | 8117 Stanford Ave, Saint Louis, MO 63130-3617 | 2010-08-02 |
| 1750543518 | Gurkiran Dhindsa | Internal Medicine | 1023 Executive Parkway Dr Ste 2, Creve Coeur, MO 63141-6323 | 2008-07-01 |
| 1538289343 | Rojanasathit,m.d.p.c. | Internal Medicine | 11155 Dunn Rd Ste 201e, Saint Louis, MO 63136-6149 | 2007-03-29 |
| 1245372226 | Robert Charles Packman | Internal Medicine | 34 Oak Park Dr, Creve Coeur, MO 63141-8428 | 2007-02-13 |
| 1528131711 | Zdzislaus Joseph Wanski | Internal Medicine | 1150 State Hwy 248 Suite 102, Branson, MO 65616 | 2006-11-16 |
| 1396840583 | Lavonne A Berg | Internal Medicine | 1551 N. Oakland, Bolivar, MO 65613 | 2006-09-13 |
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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.