GATEWAY ST LOUIS DIALYSIS LLC (NPI# 1497074520) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497074520 |
| Entity Type | Organization |
| Organization Name | GATEWAY ST LOUIS DIALYSIS LLC |
| Practice Address |
4100 Union Blvd Saint Louis MO 63115-1225 |
| Practice Telephone | 3143823480 |
| Practice Fax Number | 3143823515 |
| Mailing Telephone | 3143823480 |
| Mailing Fax Number | 3143823515 |
| Enumeration Date | 2010-05-28 |
| Last Update Date | 2020-03-11 |
| Authorized Official Name | SHARI K COUSINS (SR. VP OF CLINICAL & REGULATORY) |
| Authorized Official Telephone | 9789223080 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QE0700X |
Clinic/Center Specialization: End-Stage Renal Disease (ESRD) Treatment |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 149774520 | 05 |
| Street Address |
4100 UNION BLVD |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63115-1225 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689034860 | Jamela Love | Nurse Practitioner | 4100 Union Blvd, Unit B, Saint Louis, MO 63115-1225 | 2016-03-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871023002 | Joshua Kamau Njenga | Nurse Practitioner | 4412 Clarence Avenue, Saint Louis, MO 63115 | 2017-06-20 |
| 1417409178 | Carestl Health | Clinic/Center | 4265 Athlone Ave, Saint Louis, MO 63115 | 2016-10-28 |
| 1366806051 | Samar Roberson | Home Health | 4307 Steinlage Dr, Saint Louis, MO 63115 | 2016-04-08 |
| 1033376884 | Cornell C Thomas | Dentist | 3737 N Kings Highway, Suite 108, St Louis, MO 63115 | 2008-05-20 |
| 1033617386 | Carestl Health | Clinic/Center | 4500 Pope Ave, Saint Louis, MO 63115 | 2018-01-31 |
| 1023466984 | Carestl Health #4 | Durable Medical Equipment & Medical Supplies | 4500 Pope Ave, Saint Louis, MO 63115 | 2016-06-01 |
| 1164621538 | The Learning Tree Intergenerational Center Inc | Clinic/Center | 4430 Labadie Ave, St Louis, MO 63115 | 2007-07-16 |
| 1790845196 | Saint Louis Renal Care, LLC | Clinic/Center | 4411 N Newstead Ave, 2nd Floor, Saint Louis, MO 63115 | 2006-12-08 |
| 1245721331 | Paul Anthony Matthews Sr. | Home Health Aide | 5165 Ashland Ave, Saint Louis, MO 63115-1014 | 2018-05-23 |
| 1952946857 | Tiffany Nicole Stewart | Home Health | 5116 Greer Ave, Saint Louis, MO 63115-1017 | 2019-11-14 |
| Find all providers in zip 63115 | ||||
| Taxonomy Code | 261QE0700X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | End-Stage Renal Disease (ESRD) Treatment |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871049411 | Total Renal Care Inc | Clinic/Center | 8980 Natural Bridge Rd, Saint Louis, MO 63121-3917 | 2016-09-01 |
| 1295139459 | Meadows Dialysis LLC | Clinic/Center | 1554 Sierra Vista Plz, Saint Louis, MO 63138-2040 | 2014-10-17 |
| 1245580570 | Rainer Dialysis LLC | Clinic/Center | 3740 S Jefferson Ave, Saint Louis, MO 63118-3905 | 2012-09-13 |
| 1881980498 | Tugman Dialysis LLC | Clinic/Center | 10241 Lewis and Clark Blvd, Saint Louis, MO 63136-5505 | 2011-06-22 |
| 1316173966 | Total Renal Care Inc | Clinic/Center | 3660 Gustine Ave, Saint Louis, MO 63116-3617 | 2009-06-09 |
| 1770719700 | Total Renal Care Inc | Clinic/Center | 9030 Saint Charles Rock Rd, Saint Louis, MO 63114 | 2009-06-04 |
| 1982764387 | Saint Louis Renal Care, LLC | Clinic/Center | 5901 Delmar Blvd, Saint Louis, MO 63112-2028 | 2006-12-08 |
| 1598867772 | Saint Louis Renal Care, LLC | Clinic/Center | Drummond Hall, 3691 Rutger, Suite 222, Saint Louis, MO 63110 | 2006-09-01 |
| 1457463325 | Metro Dialysis Center - Normandy, Inc. | Clinic/Center | 101 N Oaks Plz, Saint Louis, MO 63121-2925 | 2006-08-31 |
| 1841302718 | Renex Dialysis Clinic of St. Louis, Inc. | Clinic/Center | 4030 Chouteau Ave, Saint Louis, MO 63110-1754 | 2006-08-31 |
| Find all providers in SAINT LOUIS | ||||
| City | SAINT LOUIS |
| Zip Code | 63115 |
Please comment or provide details below to improve the information on GATEWAY ST LOUIS DIALYSIS LLC.
| 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.