DR. DEREK SLOAN LARSON


Address: 12855 N 40 Dr, Suite 205, Saint Louis, MO 63141-8657
Phone: 3147200900

DR. DEREK SLOAN LARSON (NPI# 1588820096) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1588820096
Entity Type Individual
Full Name DR. DEREK SLOAN LARSON
Credential M.D.
Practice Address 12855 N 40 Dr
Suite 205
Saint Louis
MO 63141-8657
Practice Telephone 3147200900
Mailing Telephone 3147200900
Enumeration Date 2008-08-04
Last Update Date 2014-07-08
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 207RN0300X Internal Medicine
Specialization: Nephrology
036126443 IL Allopathic & Osteopathic Physicians
Y 207RN0300X Internal Medicine
Specialization: Nephrology
2014016671 MO Allopathic & Osteopathic Physicians

Other Providers DEREK LARSON

NPI Name Taxonomy Address Enumeration
1104165034 Derek Thomas Larson Internal Medicine 133 Green Meadow Dr, Portsmouth, VA 23701-1522 2013-02-13
1194731091 Derek R Larson Social Worker 2250 N 1700 W, Layton, UT 84041-1140 2006-07-31

Office Location

Street Address 12855 N 40 DR
SUITE 205
City SAINT LOUIS
State MO
Zip Code 63141-8657

Providers in the same location

NPI Name Taxonomy Address Enumeration
1942206354 St. Louis Pharmaceutical Services LLC Pharmacy 12855 N 40 Dr, Saint Louis, MO 63141-8635 2005-06-22
1700423076 Faisal Matar Nurse Practitioner 12855 N 40 Dr, Saint Louis, MO 63141-8622 2019-12-05
1750847984 Samantha Mintert Nurse Practitioner 12855 N 40 Dr, Saint Louis, MO 63141-8622 2019-02-12
1629439302 Elizabeth Galler Physician Assistant 12855 N 40 Dr, 180, Saint Louis, MO 63141-8657 2016-03-09
1992161210 Amy Thayer Nurse Practitioner 12855 N 40 Dr, Suite 180, Saint Louis, MO 63141-8657 2016-01-04
1821453796 Mason Ridge Ambulatory Surgery Center Lp Clinic/Center 12855 N 40 Dr, Suite 150, Saint Louis, MO 63141-8657 2015-12-21
1083090088 Rebecca Suzanne Roe Thomasson Physician Assistant 12855 N 40 Dr, Suite 180, Saint Louis, MO 63141-8657 2015-08-03
1891179040 Forefront Dermatology, S.c. Dermatology 12855 N 40 Dr, Suite 180, Saint Louis, MO 63141 2015-07-17
1669869657 Christopher Joseph Forsbach Podiatrist 12855 N 40 Dr, Saint Louis, MO 63141 2015-04-17
1346633930 Chesterfield Anesthesia Associates of Missouri, LLC Anesthesiology 12855 N 40 Dr, 150, Saint Louis, MO 63141-8657 2015-03-06
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Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 207RN0300X
Grouping Allopathic & Osteopathic Physicians
Classification Internal Medicine
Specialization Nephrology

Taxonomy Definition

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.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1033649819 Taewoo Lee Internal Medicine 3635 Vista Ave Saint Louis University Medical Center, Division of Nephrology, Saint Louis, MO 63110 2017-06-14
1780058727 St Louis Kidney Care LLC Internal Medicine 11155 Dunn Rd Ste 211n, Saint Louis, MO 63136-6166 2015-11-13
1184056830 Ralph Robert Hatlelid Internal Medicine 318 E Swon Ave, Saint Louis, MO 63119-3112 2013-08-05
1497000194 Siddiq Anwar Internal Medicine 660 S Euclid Ave # 8129, Renal Fellowship Program, Saint Louis, MO 63110-1010 2012-07-18
1588764724 Douglass Takashi Domoto Internal Medicine 2606 Clark Ave, Saint Louis, MO 63103-2502 2006-09-25
1699708016 Bhajanlal S Dara Internal Medicine 10160 W Florissant Ave, Suite 200, Saint Louis, MO 63136-2104 2006-07-09
1962432807 Guner Buyukkus Gulmen Internal Medicine 100 N Euclid Ave, Suite 800, Saint Louis, MO 63108-1529 2006-07-04
1710920947 Rajalakshmi T Gopalakrishnan Internal Medicine 915, North Grand Boulevard, Saint Louis, MO 63106 2006-06-14
1457348286 Kira S Mailey Internal Medicine 18 Chapel Hill Est, Saint Louis, MO 63131-1315 2005-10-06
1376166066 Nhs South LLC Internal Medicine 10004 Kennerly Rd, Saint Louis, MO 63128-2141 2020-05-28
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Competitor

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City SAINT LOUIS
Zip Code 63141

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Dataset Information

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.

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