VICTORIA CORNELIUS (NPI# 1609885607) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609885607 |
| Entity Type | Individual |
| Full Name | VICTORIA CORNELIUS |
| Credential | MD |
| Practice Address |
1465 S Grand Blvd Saint Louis MO 63104-1003 |
| Practice Telephone | 3142686406 |
| Practice Fax Number | 3142682712 |
| Mailing Telephone | 3142686406 |
| Mailing Fax Number | 3142682712 |
| Enumeration Date | 2006-08-07 |
| Last Update Date | 2019-10-25 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208000000X | Pediatrics | R8E59 | MO | Allopathic & Osteopathic Physicians |
| Y | 2080A0000X |
Pediatrics Specialization: Adolescent Medicine |
R8E59 | MO | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568925998 | Victoria Mari Cornelius | Nurse Practitioner | 11690 Timberly Ct, Richmond, VA 23238-3489 | 2019-04-11 |
| 1720251838 | Victoria L Cornelius | Durable Medical Equipment & Medical Supplies | 2751 N Packerland Dr, #103, Green Bay, WI 54303-4855 | 2008-04-09 |
| Street Address |
1465 S GRAND BLVD |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63104-1003 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528676921 | Gunjanpreet Kaur | Student in an Organized Health Care Education/Training Program | 1465 S Grand Blvd, Saint Louis, MO 63104-1003 | 2020-07-21 |
| 1972128510 | Millicent Rose Palacios | Nurse Practitioner | 1465 S Grand Blvd, Saint Louis, MO 63104-1003 | 2020-06-09 |
| 1083241863 | Nathaniel Joseph Conner | Student in an Organized Health Care Education/Training Program | 1465 S Grand Blvd, Saint Louis, MO 63104-1003 | 2020-03-24 |
| 1467089177 | Stacy Kollanur Mathews | Student in an Organized Health Care Education/Training Program | 1465 S Grand Blvd, Saint Louis, MO 63104-1003 | 2020-03-24 |
| 1568099299 | Susan Aye Mya Oo | Student in an Organized Health Care Education/Training Program | 1465 S Grand Blvd, Saint Louis, MO 63104-1003 | 2020-03-24 |
| 1861029514 | Gregory Joseph Weissler II | Student in an Organized Health Care Education/Training Program | 1465 S Grand Blvd, Saint Louis, MO 63104-1003 | 2020-03-24 |
| 1154958874 | Brendan Michael Mcenery | Student in an Organized Health Care Education/Training Program | 1465 S Grand Blvd, Saint Louis, MO 63104-1003 | 2020-03-24 |
| 1316574049 | Satvika Mikkilineni | Student in an Organized Health Care Education/Training Program | 1465 S Grand Blvd, Saint Louis, MO 63104-1003 | 2020-03-24 |
| 1972130607 | Katherine Letha Randolph | Student in an Organized Health Care Education/Training Program | 1465 S Grand Blvd, Saint Louis, MO 63104-1003 | 2020-03-24 |
| 1346877081 | Samuel Ryan Richey | Student in an Organized Health Care Education/Training Program | 1465 S Grand Blvd, Saint Louis, MO 63104-1003 | 2020-03-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407469570 | Family Care Health Centers | Clinic/Center | 2717 Sidney Street, St. Louis, MO 63104 | 2020-08-28 |
| 1023638038 | Laura Ann Humphrey | Physician Assistant | Allied Health Building 3437 Caroline Street, Room 3015, Saint Louis, MO 63104 | 2020-04-20 |
| 1174187264 | Ahsan Ali | Student in an Organized Health Care Education/Training Program | 1438 South Grand Blvd, Monteleone Hall, St. Louis, MO 63104 | 2019-04-24 |
| 1205359916 | Brenda Eve Ladin | Behavior Technician | 1221 Allen Market Lane Rear, St. Louis, MO 63104 | 2017-07-25 |
| 1841722063 | Gustavo G Mendez | Student in an Organized Health Care Education/Training Program | 1465 South Grand Bulevard Rm 2717, Ssm Health Cardinal Glennon Children's Hospital, Saint Louis, MO 63104 | 2017-03-28 |
| 1053776716 | Carmella Harper | Respiratory Therapist, Certified | 2678 Park Ave, St Louis, MO 63104 | 2015-12-23 |
| 1922485986 | Alexander Tremont | Internal Medicine | 1402 S Grand Blvd Rm M260, Saint Louis, MO 63104 | 2015-04-29 |
| 1306233341 | Healthcare R Us | Home Health | 2859 Sidney St, St Louis, MO 63104 | 2015-04-16 |
| 1396159091 | Daniela Hermelin | Pathology | 1402 South Grane, St. Louis, MO 63104 | 2014-06-20 |
| 1992117881 | Kelly Denise Durbin | Social Worker | 1920 S 7th St, Saint Louis, MO 63104 | 2014-05-27 |
| Find all providers in zip 63104 | ||||
| Taxonomy Code | 2080A0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Adolescent Medicine |
| A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114048154 | Affton Medical Clinic | Pediatrics | 59 Grasso Plz, Saint Louis, MO 63123-3107 | 2007-04-03 |
| 1932328796 | St Louis University | Pediatrics | 1465 S Grand Blvd, Saint Louis, MO 63104-1003 | 2007-04-24 |
| 1760556708 | Ariane E May | Pediatrics | 4055 Lindell Blvd, Saint Louis, MO 63108-3201 | 2006-11-20 |
| 1518030097 | Jill M. Baer | Pediatrics | 3009 N Ballas Rd, Suite 257-c, Saint Louis, MO 63131-2322 | 2006-11-15 |
| 1801999768 | Joyce D Johnson | Pediatrics | 6744 Clayton Rd, Saint Louis, MO 63117-1637 | 2006-09-06 |
| 1730295759 | Joseph Prusaczyk | Pediatrics | 13035 Olive Blvd, Saint Louis, MO 63141-6173 | 2006-08-22 |
| 1649292780 | Sarah Ann Tycast | Pediatrics | 1 Childrens Pl, Saint Louis, MO 63110-1002 | 2006-07-25 |
| 1528081544 | Lynn K White | Pediatrics | 1 Childrens Pl, Saint Louis, MO 63110-1002 | 2006-07-25 |
| 1023036746 | Maryjo Hernandez-zipfel | Pediatrics | 4055 Lindell Blvd, Saint Louis, MO 63108-3201 | 2006-07-18 |
| 1750310439 | Amal F Antoun | Pediatrics | 1717 Biddle St, Saint Louis, MO 63106-3454 | 2006-07-03 |
| Find all providers in SAINT LOUIS | ||||
| City | SAINT LOUIS |
| Zip Code | 63104 |
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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.