MERCY CLINIC CARDIOVASCULAR AND THORACIC SURGERY, LLC (NPI# 1538181466) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538181466 |
| Entity Type | Organization |
| Organization Name | MERCY CLINIC CARDIOVASCULAR AND THORACIC SURGERY, LLC |
| Other Organization Name | ST. JOHN'S MERCY CARDIOVASCULAR AND THORACIC SURGERY ASSOCIATES LLC |
| Practice Address |
625 S New Ballas Rd Suite R-7040 Saint Louis MO 63141-8232 |
| Practice Telephone | 3142516970 |
| Practice Fax Number | 3142511053 |
| Mailing Telephone | 3142516970 |
| Mailing Fax Number | 3142511053 |
| Enumeration Date | 2006-07-23 |
| Last Update Date | 2014-05-08 |
| Authorized Official Name | JOHN W. HUBERT (PRESIDENT) |
| Authorized Official Telephone | 3142511700 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | Y |
| Parent Organization Name | MERCY CLINIC EAST COMMUNITIES |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 509347407 | 05 |
| Other Name | Type Code |
|---|---|
| St. John's Mercy Cardiovascular and Thoracic Surgery Associates LLC | Former Legal Business Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528192416 | Mercy Clinic Cardiovascular and Thoracic Surgery, LLC | Surgery | 851 E 5th St, Suite 304, Washington, MO 63090-3135 | 2007-03-15 |
| Street Address |
625 S NEW BALLAS RD SUITE R-7040 |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63141-8232 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295738201 | Louis P Stickley | Internal Medicine | 625 S New Ballas Rd, Ste 2030, Saint Louis, MO 63141-8253 | 2005-05-23 |
| 1275078339 | Anne Elizabeth Robinson | Physician Assistant | 625 S New Ballas Rd, Suite R-7040, Saint Louis, MO 63141-8253 | 2016-12-28 |
| 1548705601 | Renee Suzanne Kertz | Physician Assistant | 625 S New Ballas Rd, Suite R-7040, Saint Louis, MO 63141-8253 | 2016-12-28 |
| 1407399736 | Nicole Michelle Rohr | Nurse Practitioner | 625 S New Ballas Rd, Suite 2015, Saint Louis, MO 63141-8253 | 2016-11-18 |
| 1437691540 | Danielle Getsee | Physician Assistant | 625 S New Ballas Rd, Saint Louis, MO 63141-8253 | 2016-11-07 |
| 1093165946 | Catherine Ann Vasilevski | Internal Medicine | 625 S New Ballas Rd, Saint Louis, MO 63141-8253 | 2016-06-21 |
| 1932557964 | Leah Jones | Nurse Practitioner | 625 S New Ballas Rd, Saint Louis, MO 63141-8253 | 2016-05-31 |
| 1154782340 | Mercy Hospital St. Louis Professional Surgical Services LLC | Surgery | 625 S New Ballas Rd, Saint Louis, MO 63141-8253 | 2016-03-15 |
| 1568848414 | Kyle Hoff | Physician Assistant | 625 S New Ballas Rd, Suite R7040, Saint Louis, MO 63141-8253 | 2015-08-03 |
| 1841613205 | Nora Elizabeth O'brien | Nurse Practitioner | 625 S New Ballas Rd, Suite 20130, Saint Louis, MO 63141-8253 | 2014-01-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679102842 | Noor Ramadan | Pharmacist | 628 North New Ballad Road, Suite A, Creve Coeur, MO 63141 | 2020-04-08 |
| 1497381206 | Washington University | Durable Medical Equipment & Medical Supplies | 1044 North Mason Road, Suite 110/210, St. Louis, MO 63141 | 2020-03-13 |
| 1154956498 | Ashleigh Clendenny | Physician Assistant | Mercy Hospital St. Louis, 615 S New Ballas Rd, St. Louis, MO 63141 | 2020-03-06 |
| 1801429410 | Emili Lou Haley | Registered Nurse | 650 Maryville Drive, St Louis, MO 63141 | 2020-02-21 |
| 1629553110 | Rebecca Kathleen Pike | Social Worker | West County Psychological Associates, 12125 Woodcrest Executive Drive #110, St. Louis, MO 63141 | 2018-10-01 |
| 1649756099 | River City Sedation Associates, LLC | Nurse Anesthetist, Certified Registered | 12855 N 40 Dr Ste 150, Saint Louis, MO 63141 | 2018-07-18 |
| 1205333952 | Ear Care and Hearing of St. Louis | Hearing Aid Equipment | 11630 Studt Ave Ste 210, Creve Coeur, MO 63141 | 2018-04-10 |
| 1659897486 | Erin Goodman | Physical Therapist | 10560 Old Olive St. Rd, Suite 100, Creve Coeur, MO 63141 | 2017-08-14 |
| 1093230450 | Center for Urologic Surgery LLC | Clinic/Center | 12855 N 40 Dr Ste 100, Saint Louis, MO 63141 | 2017-08-07 |
| 1871016105 | Jacob Farley Tanner | Specialist/Technologist | 1054 Town and Four Parkway Dr, Creve Coeur, MO 63141 | 2017-07-19 |
| Find all providers in zip 63141 | ||||
| Taxonomy Code | 208G00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Thoracic Surgery (Cardiothoracic Vascular Surgery) |
| A thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the surgical care of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the trachea, abnormalities of the great vessels and heart valves, congenital anomalies, tumors of the mediastinum and diseases of the diaphragm. The management of the airway and injuries of the chest is within the scope of the specialty. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Thoracic Surgery, 2007. http://www.abts.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Thoracic Surgery. Thoracic surgeons have the knowledge, experience and technical skills to accurately diagnose, operate upon safely, and effectively manage patients with thoracic diseases of the chest. This requires substantial knowledge of cardiorespiratory physiology and oncology, as well as capability in the use of heart assist devices, management of abnormal heart rhythms and drainage of the chest cavity, respiratory support systems, endoscopy and invasive and noninvasive diagnostic techniques. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891034484 | John Phillip Connors | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1733 Kenmont Rd, Saint Louis, MO 63124-1021 | 2013-02-03 |
| 1578634226 | Nabil A Munfakh | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 11155 Dunn Rd Ste 209e, Ste 209e, Saint Louis, MO 63136-6149 | 2006-11-13 |
| 1649355355 | Michael C Murphy | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 3009 N Ballas Rd Ste 150d, Saint Louis, MO 63131-2322 | 2006-10-25 |
| 1972614576 | Nicholas Kouchoukos | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 3023 N Ballas Rd Ste 150d, Saint Louis, MO 63131-2319 | 2006-08-31 |
| 1124066550 | John Codd | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 126 Southarm Dr, Saint Louis, MO 63122-4658 | 2006-06-04 |
| 1780636571 | Pirooz Eghtesady | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1 Childrens Pl Ste 5s50, Ste 5s50, Saint Louis, MO 63110-1002 | 2006-05-17 |
| 1134788136 | Chawannuch Ruaengsri | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1 Barnes Jewish Hospital Plz, Saint Louis, MO 63110-1003 | 2019-06-12 |
| 1639606106 | Tsuyoshi Takahashi | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1 Barnes Jewish Hospital Plz, Saint Louis, MO 63110-1003 | 2017-05-16 |
| 1518333558 | Orlando Petrucci | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1 Childrens Pl, Ste 5s50, Saint Louis, MO 63110-1002 | 2015-08-13 |
| 1609131879 | William Arthue Gay Jr. | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1 Barnes Jewish Hospital Plz, Suite 3108 Queeny Tower, Saint Louis, MO 63110-1003 | 2012-07-12 |
| Find all providers in SAINT LOUIS | ||||
| City | SAINT LOUIS |
| Zip Code | 63141 |
Please comment or provide details below to improve the information on MERCY CLINIC CARDIOVASCULAR AND THORACIC SURGERY, 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.