DCCT (NPI# 1588818975) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588818975 |
| Entity Type | Organization |
| Organization Name | DCCT |
| Practice Address |
1423 S Big Bend Blvd Saint Louis MO 63117-2203 |
| Mailing Address |
Po Box 9169 Saint Louis MO 63117-0169 |
| Practice Telephone | 3146108169 |
| Mailing Telephone | 3146108169 |
| Enumeration Date | 2008-11-11 |
| Last Update Date | 2008-11-13 |
| Authorized Official Name | DR. REZA ROFOUGARAN (CEO) |
| Authorized Official Telephone | 3146108169 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | 101819 | MO | Ambulatory Health Care Facilities |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | DCCT AUTO, INC. | 29887 Kelso St, Eugene, OR 97402 |
| New York State Corporations | DCCT CARE LLC | 63 Van Wagner Road, Poughkeepsie, Ny 12603 |
| Street Address |
1423 S BIG BEND BLVD |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63117-2203 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124139845 | Lamice El-kholy | Internal Medicine | 1423 S Big Bend Blvd, Saint Louis, MO 63117-2203 | 2006-08-31 |
| 1053756759 | Susan Becker Leon | Nurse Practitioner | 1423 S Big Bend Blvd, Saint Louis, MO 63117-2203 | 2013-05-08 |
| 1073884862 | Renee R Schnelker | Clinical Nurse Specialist | 1423 S Big Bend Blvd, Saint Louis, MO 63117-2203 | 2012-01-25 |
| 1043581556 | Courtney Chad Alan Singrey | Nurse Practitioner | 1423 S Big Bend Blvd, Saint Louis, MO 63117-2203 | 2012-01-16 |
| 1396803995 | Clayton Endocrinology LLC | Internal Medicine | 1423 S Big Bend Blvd, Saint Louis, MO 63117-2203 | 2006-12-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255956611 | Efehi Kelly Ogbomo | Student in an Organized Health Care Education/Training Program | 6420 Clayton Rd, Suite 2218, St. Louis, MO 63117 | 2020-06-11 |
| 1619533890 | Abdul Rauf | Student in an Organized Health Care Education/Training Program | 6420 Clayton Road. Ssm Health St. Mary's Hospital, St. Louis, MO 63117 | 2019-05-14 |
| 1083278477 | Mohamed Maali Gumaa Mohamed | Student in an Organized Health Care Education/Training Program | 6420 Clayton Road Ssm St. Mary's Hospital, Department of Internal Medicine, St. Louis, MO 63117 | 2019-05-01 |
| 1750945556 | Samrat Jun Jayanth | Student in an Organized Health Care Education/Training Program | 6420 Clayton Road, Ssm Health St Mary's Hospital, St. Louis, MO 63117 | 2019-04-26 |
| 1215491329 | Latonya Allen | Counselor | 1612 S. Big Bend Blvd, St. Louis, MO 63117 | 2019-01-23 |
| 1265917025 | Blue Stars Therapy, LLC | Occupational Therapist | 1101 Edward Terrace, Apt A, St. Louis, MO 63117 | 2018-09-27 |
| 1770060014 | Ultra Care Home Services LLC | Home Health | 7353 Dale Ave, Saint Louis, MO 63117 | 2018-07-19 |
| 1235623562 | Melissa Valerie Taylor | Counselor | Psychological Services of St Louis, LLC, 7110 Oakland Ave, St Louis, MO 63117 | 2018-06-20 |
| 1124517289 | Jideofor Ebony Obodozie | Student in an Organized Health Care Education/Training Program | 6420 Clayton Road, Ssm St. Mary's Hospital, St. Louis, MO 63117 | 2018-05-04 |
| 1770071706 | Sivaram Prabhuji Muppaneni | Student in an Organized Health Care Education/Training Program | Ssm St Mary's Hospital, 6420 Clayton Road, St. Louis, MO 63117 | 2018-04-25 |
| Find all providers in zip 63117 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871112102 | Thrive St. Louis, Inc | Clinic/Center | 4331 Lindell Blvd, Saint Louis, MO 63108-2701 | 2020-04-16 |
| 1548893530 | Gateway Direct Primary Care Jv LLC | Clinic/Center | 1015 Corporate Square Dr Ste 101, Saint Louis, MO 63132-2938 | 2020-02-18 |
| 1740722230 | Saint Louis Allergy and Asthma Lc | Clinic/Center | 6651 Chippewa St Ste 312, Saint Louis, MO 63109-2532 | 2016-11-15 |
| 1609245448 | Carestl Health | Clinic/Center | 4500 Pope Ave, Saint Louis, MO 63115-2512 | 2015-09-23 |
| 1538586037 | Advanced Cardiovascular Center LLC | Clinic/Center | 2335 Dougherty Ferry Rd, Suite A, Saint Louis, MO 63122-3313 | 2014-03-21 |
| 1871865881 | North County Health Care, Inc | Clinic/Center | 9231 West Florissant, Saint Louis, MO 63136-1432 | 2012-02-07 |
| 1013195478 | Union Manor Residential Care Facility | Clinic/Center | 2711 Union Blvd, Saint Louis, MO 63113-1003 | 2008-02-07 |
| 1497771653 | Instaclinic, LLC | Clinic/Center | 10805 Sunset Office Dr, Suite 300, Saint Louis, MO 63127-1017 | 2006-07-14 |
| 1508867508 | Family Care Health Centers | Clinic/Center | 401 Holly Hills Ave, Saint Louis, MO 63111-2410 | 2005-08-02 |
| 1346847233 | Washington University | Clinic/Center | 8888 Ladue Rd Ste 100, Saint Louis, MO 63124-2056 | 2020-10-05 |
| Find all providers in SAINT LOUIS | ||||
| City | SAINT LOUIS |
| Zip Code | 63117 |
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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.