DR. ROUBA GHOUSSOUB (NPI# 1396964599) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396964599 |
| Entity Type | Individual |
| Full Name | DR. ROUBA GHOUSSOUB |
| Credential | M.D. |
| Practice Address |
4600 Memorial Dr Suite 330 Belleville IL 62226-5368 |
| Mailing Address |
4500 Memorial Drive Credentialing Dept Memorial Hospital Medical Affairs Belleville IL 62226 |
| Practice Telephone | 6182346003 |
| Mailing Telephone | 6182574644 |
| Enumeration Date | 2007-04-25 |
| Last Update Date | 2015-07-02 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RN0300X |
Internal Medicine Specialization: Nephrology |
2007011138 | MO | Allopathic & Osteopathic Physicians |
| Street Address |
4600 MEMORIAL DR SUITE 330 |
| City | BELLEVILLE |
| State | IL |
| Zip Code | 62226-5368 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245234988 | Ellen Middendorf | Family Medicine | 4600 Memorial Dr, Ste. 160, Belleville, IL 62226-5368 | 2005-06-10 |
| 1922594142 | Keli Nicole Keener | Specialist/Technologist | 4600 Memorial Dr, Belleville, IL 62226-5368 | 2018-07-11 |
| 1952849770 | Kendra Jane Green | Nurse Practitioner | 4600 Memorial Dr, Ste 80, Belleville, IL 62226-5359 | 2017-02-01 |
| 1427504042 | Catherine Bennett | Nurse Practitioner | 4600 Memorial Dr, Suite 200, Belleville, IL 62226-5368 | 2016-09-01 |
| 1558738237 | Christina Moore | Physician Assistant | 4600 Memorial Dr, Suite 200, Belleville, IL 62226-5368 | 2015-08-28 |
| 1588056147 | Miranda Boeckman | Physician Assistant | 4600 Memorial Dr, Belleville, IL 62226-5368 | 2015-02-19 |
| 1033510284 | Msa Alliance, LLC Dba-southern Illinois Vascular and Vein Surgery | Surgery | 4600 Memorial Dr, Suite120, Belleville, IL 62226-5368 | 2014-09-08 |
| 1548680267 | Msa Alliance, LLC | Surgery | 4600 Memorial Dr, Suite W2, Belleville, IL 62226-5368 | 2014-04-21 |
| 1770925760 | Msa Alliance, LLC | Internal Medicine | 4600 Memorial Dr, Suite 200, Belleville, IL 62226-5368 | 2013-07-19 |
| 1982045514 | Ashley A. Wittler | Nurse Practitioner | 4600 Memorial Dr, Ste. 400, Belleville, IL 62226-5368 | 2013-07-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639778160 | Roxanna Lee Gunnels | Nurse Practitioner | 1 Bronze Pointe Plaza Suite 1a, Swansea, IL 62226 | 2020-10-26 |
| 1053969790 | Consistent Medical Transportation | Driver | 2012 N 17th St, Swansea, IL 62226 | 2019-08-27 |
| 1497314371 | Medi-plex Hospice of Illinois, LLC | Registered Nurse | 8 Park Place, Suite #3, Swansea, IL 62226 | 2019-06-13 |
| 1336617364 | Nicole Renee Schmidt | Speech-Language Pathologist | 150 N 27th St., Belleville, IL 62226 | 2018-11-07 |
| 1295258903 | Catherine Espino | Pharmacist | 11 Chambers Blvd, Swansea, IL 62226 | 2017-07-25 |
| 1366806838 | Kiley Faires | Nurse Practitioner | 4600 Memorial Drive Ste 360, Belleville, IL 62226 | 2016-04-11 |
| 1760857585 | Mvp Transportation | Non-emergency Medical Transport (VAN) | 1229 N 17th Street, Number 23, Belleville, IL 62226 | 2015-12-04 |
| 1275952566 | Aisha Danyale Franklin | Internal Medicine | 4261 Woodfield Pl, Belleville, IL 62226 | 2014-04-15 |
| 1396168332 | Jayne E. Ninness | Physical Therapy Assistant | 4500 Memorial Dr., Memorial Hospital, Belleville, IL 62226 | 2014-01-28 |
| 1053758193 | Gateway Foundation, Inc. | Clinic/Center | 1 Bronze Point, Suite 1, Swansea, IL 62226 | 2013-05-30 |
| Find all providers in zip 62226 | ||||
| Taxonomy Code | 207RN0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Nephrology |
| An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. |
| 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 |
|---|---|---|---|---|
| 1588767875 | Gayithri R Keshav | Internal Medicine | 140 Belmont Ave, Ste 103, Belleville, NJ 07109-1018 | 2006-09-05 |
| 1174505978 | Donald David Rose | Internal Medicine | 521 Lake Christine Dr, Belleville, IL 62221-5101 | 2005-11-17 |
| 1194706564 | Marcia Lynn Wendland | Internal Medicine | 5105 W Main St, Belleville, IL 62226-4728 | 2005-11-10 |
| 1104294909 | Roger Keshav Md Pa | Internal Medicine | 140 Belmont Ave, Suite 102, Belleville, NJ 07109-1018 | 2015-09-10 |
| 1922314996 | Msa Alliance, LLC | Internal Medicine | 4600 Memorial Dr, Suite 330, Belleville, IL 62226-5368 | 2010-08-27 |
| 1699089060 | Msa Alliance, LLC | Internal Medicine | 4550 Memorial Dr, Ste 410, Belleville, IL 62226-5372 | 2010-07-28 |
| 1942525316 | Roger Keshav | Internal Medicine | 140 Belmont Ave, Belleville, NJ 07109-1018 | 2010-03-29 |
| 1235267808 | David Rose, M.d. Ltd | Internal Medicine | 5105 W Main St, Belleville, IL 62226-4728 | 2007-03-02 |
| 1073625117 | Penny E Defranco | Internal Medicine | 5 Franklin Ave, Suite 401, Belleville, NJ 07109-3532 | 2006-08-31 |
| 1962514018 | Ranka Samsa | Internal Medicine | 5 Franklin Ave, Suite 401, Belleville, NJ 07109-3532 | 2006-08-31 |
| Find all providers in BELLEVILLE | ||||
| City | BELLEVILLE |
| Zip Code | 62226 |
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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.