DR. JUSTIN GRADY (NPI# 1669882205) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669882205 |
| Entity Type | Individual |
| Full Name | DR. JUSTIN GRADY |
| Credential | D.O. |
| Practice Address |
615 S New Ballas Rd Saint Louis MO 63141-8221 |
| Practice Telephone | (314) 251-6930 |
| Mailing Telephone | (314) 251-6930 |
| Enumeration Date | 2014-05-05 |
| Last Update Date | 2018-03-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0200X |
Internal Medicine Specialization: Critical Care Medicine |
2017021034 | MO | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | MO | Student, Health Care |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 6420 Clayton Rd, Department of Internal Medicine, Saint Louis, MO 631171811 | 3147688778 |
| Street Address |
615 S NEW BALLAS RD |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63141-8221 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780689182 | Robert W Allen | Anesthesiology | 615 S New Ballas Rd, Saint Louis, MO 63141-8221 | 2005-06-14 |
| 1033722061 | Ashley Maull | Nurse Practitioner | 615 S New Ballas Rd, Saint Louis, MO 63141-8221 | 2020-08-28 |
| 1508476367 | Ryan Nathan | Student in an Organized Health Care Education/Training Program | 615 S New Ballas Rd, Saint Louis, MO 63141-8221 | 2020-08-06 |
| 1992315857 | Corey Weicht | Nurse Practitioner | 615 S New Ballas Rd, Saint Louis, MO 63141-8221 | 2020-08-05 |
| 1063021905 | Alexandria Colleen Grodie | Nurse Practitioner | 615 S New Ballas Rd, Saint Louis, MO 63141-8221 | 2020-07-27 |
| 1396353892 | Fahad Bin Tahir | Internal Medicine | 615 S New Ballas Rd, Saint Louis, MO 63141-8221 | 2020-07-21 |
| 1588281307 | Alexander Cai | Dentist | 615 S New Ballas Rd, Saint Louis, MO 63141-8221 | 2020-06-26 |
| 1083231070 | Lauren Gonzalez | Anesthesiologist Assistant | 615 S New Ballas Rd, Saint Louis, MO 63141-8221 | 2020-06-25 |
| 1780200253 | Matthew Davis | Internal Medicine | 615 S New Ballas Rd, Saint Louis, MO 63141-8221 | 2020-06-22 |
| 1902422421 | Megan Reidy Landis | Family Medicine | 615 S New Ballas Rd, Saint Louis, MO 63141-8221 | 2020-06-20 |
| 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 | 207RC0200X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Critical Care Medicine |
| An internist who diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists. |
| 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. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275845208 | Jimmy L Moss | Internal Medicine | 12634 Olive Blvd Dept Of, Saint Louis, MO 63141-6337 | 2010-07-07 |
| 1871585356 | Salvador Lobianco | Internal Medicine | 11155 Dunn Rd, Ste: 315e, Saint Louis, MO 63136-6150 | 2005-08-19 |
| 1235121013 | Nadeem D Parkar | Internal Medicine | 3635 Vista At Grand, Radiology Dept - Sluh, Saint Louis, MO 63110-0250 | 2005-08-18 |
| 1376546804 | Nadeem Ahmed | Internal Medicine | 777 Craig Rd Ste 130, Saint Louis, MO 63141-7133 | 2005-05-30 |
| 1194255455 | Christopher David Coriasso | Internal Medicine | 625 S New Ballas Rd Ste 7020, Saint Louis, MO 63141-8218 | 2017-06-19 |
| 1760815740 | Inpatient Consultants of Missouri Inc | Internal Medicine | 12125 Woodcrest Executive Dr Ste 220, Saint Louis, MO 63141-5010 | 2013-08-14 |
| 1083977367 | Peter Kang | Internal Medicine | 1 Barnes Jewish Hospital Plz, Saint Louis, MO 63110-1003 | 2012-06-21 |
| 1861758526 | Keith Timothy Ferguson | Internal Medicine | 3660 Vista Ave, Saint Louis, MO 63110-2540 | 2012-04-06 |
| 1013203454 | Karthik Iyer | Internal Medicine | 1100 S Grand Blvd, Drc 831, Saint Louis, MO 63104-1015 | 2011-06-23 |
| 1285954743 | Elizabethann Nadine Raitz-cowboy | Internal Medicine | 999 Executive Parkway Dr Ste 210, Saint Louis, MO 63141-6336 | 2010-06-08 |
| Find all providers in SAINT LOUIS | ||||
| City | SAINT LOUIS |
| Zip Code | 63141 |
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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.