ROBERT ELROY KRAETSCH (NPI# 1609839281) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609839281 |
| Entity Type | Individual |
| Full Name | ROBERT ELROY KRAETSCH |
| Credential | MD |
| Practice Address |
400 Medical Plz Suite 100 Lake St Louis MO 63367-1490 |
| Mailing Address |
500 Medical Dr Wentzville MO 63385-3421 |
| Practice Telephone | 6366398600 |
| Practice Fax Number | 6366398666 |
| Mailing Telephone | 6363271202 |
| Mailing Fax Number | 3633271222 |
| Enumeration Date | 2006-04-06 |
| Last Update Date | 2012-08-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
R6140 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AETNA | 4000561 | 01 | |
| RR MEDICARE | 110189320 | 01 | |
| MO | BCBS | 121347 | 01 |
| HEALTHLINK | 134622 | 01 | |
| MO | 202536827 | 05 | |
| UHC | 3603013 | 01 | |
| GHP | 58811 | 01 |
| Street Address |
400 MEDICAL PLZ SUITE 100 |
| City | LAKE ST LOUIS |
| State | MO |
| Zip Code | 63367-1490 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700335999 | Katherine Schroer | Nurse Practitioner | 400 Medical Plz, Suite 200, Lake St Louis, MO 63367-1490 | 2016-09-28 |
| 1235532193 | Jamee Vester | Nurse Practitioner | 400 Medical Plz, Lake St Louis, MO 63367-1490 | 2014-10-06 |
| 1093139859 | Christine Benson | Physician Assistant | 400 Medical Plz, Radiation Oncolocy, Lake St Louis, MO 63367-1490 | 2014-02-13 |
| 1962832980 | Megan Nichoalds | Nurse Practitioner | 400 Medical Plz, Suite 200, Lake St Louis, MO 63367-1490 | 2013-11-13 |
| 1518396670 | Ssm St Charles Clinic Medical Group | Nurse Practitioner | 400 Medical Plz, Suite 200, Lake St Louis, MO 63367-1490 | 2013-11-08 |
| 1023071347 | John David Wilkes | Internal Medicine | 400 Medical Plz, Suite 100, Lake St Louis, MO 63367-1490 | 2006-04-08 |
| 1508829177 | James Von Beattie | Internal Medicine | 400 Medical Plz, Suite 100, Lake St Louis, MO 63367-1490 | 2006-04-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295376697 | Stacy Brown | Counselor | 1216 Flagstone Terrace, Lake St. Louis, MO 63367 | 2019-10-07 |
| 1083172449 | Katie D Schmidt | Nurse Practitioner | 300 Medical Plz Ste 150, Lake St Louis, MO 63367 | 2019-03-05 |
| 1932639739 | Eren Taylor-scaggs | Social Worker | 112 Lake St. Louis Blvd, Lake St. Louis, MO 63367 | 2017-06-14 |
| 1184169203 | Be The Change Counseling Services | Community/Behavioral Health | 206 Centre On The Lake, Lake St. Louis, MO 63367 | 2016-12-28 |
| 1568812535 | Brittanie Weinhaus | Family Medicine | 6261 Ronald Regan Dr Ste #b19, Lake St. Louis, MO 63367 | 2016-06-20 |
| 1821445099 | Matt Beamer | Skilled Nursing Facility | 2885 Technology Drive, Lake St. Louis, MO 63367 | 2016-05-18 |
| 1710349642 | Jennifer Gandolfo | Early Intervention Provider Agency | 710 Abbottsford Ct., Lake St. Louis, MO 63367 | 2016-03-21 |
| 1760862361 | Joaquin Francisco Sumaya | Chiropractor | 11104 Veterans Memorial Pkwy., Lake Saint Louis, MO 63367 | 2015-06-09 |
| 1619214566 | Daniel Scott Terry | Counselor | 1000 Edgewater Pt Ste 401, Lake St Louis, MO 63367 | 2013-01-12 |
| 1437415551 | Cherie Jean Coletta | Nurse Practitioner | 100 Medical Plaza Dr, Emergency Department, Lake Saint Louis, MO 63367 | 2012-04-03 |
| Find all providers in zip 63367 | ||||
| Taxonomy Code | 207RH0003X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Hematology & Oncology |
| An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023071347 | John David Wilkes | Internal Medicine | 400 Medical Plz, Suite 100, Lake St Louis, MO 63367-1490 | 2006-04-08 |
| 1508829177 | James Von Beattie | Internal Medicine | 400 Medical Plz, Suite 100, Lake St Louis, MO 63367-1490 | 2006-04-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922485986 | Alexander Tremont | Internal Medicine | 1402 S Grand Blvd Rm M260, Saint Louis, MO 63104 | 2015-04-29 |
| 1538564620 | Bader Alahmari | Internal Medicine | 660 South Euclid Avenue Campus Box 8007, St Louis, MO 63110 | 2014-10-31 |
| 1235480708 | James Michael Epstein | Internal Medicine | 12008 Heatherdane Dr, Saint Louis, MO 63131-3119 | 2012-09-25 |
| 1285920694 | Zhineng Jayson Yang | Internal Medicine | 2529 Glenn Hendren Dr Ste G30, Liberty, MO 64068-9610 | 2011-06-23 |
| 1477782092 | Tamara V Hopkins, Md, LLC | Internal Medicine | 2009 Saint Marys Blvd Ste A, Jefferson City, MO 65109-1509 | 2009-07-02 |
| 1457591463 | David Douglas Westhoff | Internal Medicine | 3605 Missouri Blvd, Jefferson City, MO 65109-7111 | 2009-03-03 |
| 1629224357 | Vinay Gupta | Internal Medicine | 110 Ne Saint Lukes Blvd Ste 500, Lees Summit, MO 64086-6075 | 2008-08-13 |
| 1942456058 | Anuj Shrestha | Internal Medicine | 2310 Holmes St Ste 500, Kansas City, MO 64108-2602 | 2008-08-09 |
| 1154580777 | Skaggs Community Hospital Association | Internal Medicine | 525 Branson Landing Blvd Ste 101, Branson, MO 65616-2052 | 2008-06-09 |
| 1326235797 | Getinet Degu Ayalew | Internal Medicine | 12277 De Paul Dr Ste 100, Bridgeton, MO 63044-2577 | 2007-10-01 |
| Find all providers with the same taxonomy | ||||
| City | LAKE ST LOUIS |
| Zip Code | 63367 |
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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.