EAR NOSE THROAT MEDICAL SERVICE (NPI# 1407490105) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407490105 |
| Entity Type | Organization |
| Organization Name | EAR NOSE THROAT MEDICAL SERVICE |
| Practice Address |
4800 Mexico Rd Ste 103 Saint Peters MO 63376-1666 |
| Mailing Address |
1324 Clarkson Clayton Ctr Ste 301 Ellisville MO 63011-2145 |
| Practice Telephone | 6369365002 |
| Mailing Telephone | 3145416838 |
| Enumeration Date | 2019-11-05 |
| Last Update Date | 2019-11-05 |
| Authorized Official Name | KATHLEEN BURK (DESIGNATED OFFICIAL) |
| Authorized Official Telephone | 3145416838 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207YX0905X |
Otolaryngology Specialization: Otolaryngology/Facial Plastic Surgery |
Allopathic & Osteopathic Physicians |
| Street Address |
4800 MEXICO RD STE 103 |
| City | SAINT PETERS |
| State | MO |
| Zip Code | 63376-1666 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942234331 | Gordon C Knight | Surgery | 4800 Mexico Rd Ste 103, Saint Peters, MO 63376-1666 | 2006-07-10 |
| 1003336819 | Hodag Medical Services, LLC | Otolaryngology | 4800 Mexico Rd Ste 103, Saint Peters, MO 63376-1666 | 2017-06-22 |
| 1013935816 | St. Louis Heart Institute Cardiothoracic Surgeons, Inc. | Surgery | 4800 Mexico Rd Ste 103, Saint Peters, MO 63376-1666 | 2006-07-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275047946 | Nicholas Christian Schultz | Dentist | 100 Piper Hill Dr Ste A, Saint Peters, MO 63376 | 2017-11-16 |
| 1982120093 | Carol Weber | Speech-Language Pathologist | 166 Boone Hills Dr., St Peters, MO 63376 | 2017-08-21 |
| 1619424744 | Forefront Dermatology, S.c. | Dermatology | 5700 Mexico Rd, Suite 14, Saint Peters, MO 63376 | 2016-09-07 |
| 1508310632 | Preferred Family Healthcare, Inc. | Counselor | 2120 Parkway Dr, Saint Peters, MO 63376 | 2016-08-05 |
| 1598130676 | Delta Center Personal Attendant Services | In Home Supportive Care | 3833 Mcclay, Suite 61, St. Peters, MO 63376 | 2015-12-01 |
| 1427420314 | Barbara Marlene Edelman | Counselor | 1286 Jungerman Rd. Suite G, St. Peters, MO 63376 | 2015-10-30 |
| 1255740247 | Claire Williams | Dentist | 340 Mid Rivers Mall Drive, Suite E, St. Peters, MO 63376 | 2014-08-05 |
| 1184042855 | Keith Wickenhauser | Internal Medicine | 201 Bjc Saint Peters Dr Ste 100, Saint Peters, MO 63376 | 2014-03-31 |
| 1821415233 | Abby Link | Physician Assistant | 107 Piper Parkway, #150, St. Peters, MO 63376 | 2014-03-24 |
| 1225452105 | Ashley Gagel | Physical Therapist | 7055 Mexico Rd Suite 1601, St. Peters, MO 63376 | 2014-02-12 |
| Find all providers in zip 63376 | ||||
| Taxonomy Code | 207YX0905X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| Specialization | Otolaryngology/Facial Plastic Surgery |
| An otolaryngologist who specializes in the diagnosis and surgical treatment of head and neck conditions. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate is issued by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407047178 | Edment, LLC | Otolaryngology | 5780 Highway 54, Suite 113, Osage Beach, MO 65065-3043 | 2007-08-07 |
| 1194876805 | Edgar N Kemp IIi | Otolaryngology | 1605 South Baltimore, Suite B, Kirksville, MO 63501 | 2007-01-16 |
| 1336209675 | Richard Hyrum Woodland | Otolaryngology | 1602 N 2nd, Clinton, MO 64735-1192 | 2006-12-09 |
| 1629161864 | Kelly Douglas Burchett | Otolaryngology | 1605 South Baltomore, Suite B, Kirksville, MO 63501 | 2006-10-02 |
| 1023120110 | James Mead Gaunt | Otolaryngology | 1710 S Lafayette Ave, Sedalia, MO 65301-7542 | 2006-08-31 |
| 1457331324 | Kent Douglas Mcintire | Otolaryngology | 1331 W 32nd St, Joplin, MO 64804 | 2006-01-18 |
| 1457351033 | Frank W Shagets | Otolaryngology | 620 W 32nd St, Suite B, Joplin, MO 64804-2549 | 2005-07-26 |
| 1730539974 | Talon Maningas D.o. LLC | Otolaryngology | 620 W 32nd St Ste B, Joplin, MO 64804-2528 | 2016-06-19 |
| 1609244193 | Heather A Curtis | Otolaryngology | 6500 Hospital Dr, Hannibal, MO 63401-6890 | 2015-09-14 |
| 1730469693 | Martin Ear Nose & Throat Clinic | Otolaryngology | 37 Doctors Park, Suite 1, Cape Girardeau, MO 63703-4956 | 2011-08-24 |
| Find all providers with the same taxonomy | ||||
| City | SAINT PETERS |
| Zip Code | 63376 |
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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.