CHILDREN'S GASTROENTEROLOGY OF ST. LOUIS, P.C. (NPI# 1679699060) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679699060 |
| Entity Type | Organization |
| Organization Name | CHILDREN'S GASTROENTEROLOGY OF ST. LOUIS, P.C. |
| Practice Address |
224 S Woods Mill Rd Ste 640 Chesterfield MO 63017-3451 |
| Practice Telephone | 3145762080 |
| Practice Fax Number | 3145760028 |
| Mailing Telephone | 3145762080 |
| Mailing Fax Number | 3145760028 |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. JERRY L ROSENBLUM (PRESIDENT) |
| Authorized Official Telephone | 3145762080 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0206X |
Pediatrics Specialization: Pediatric Gastroenterology |
Allopathic & Osteopathic Physicians |
| Street Address |
224 S WOODS MILL RD STE 640 |
| City | CHESTERFIELD |
| State | MO |
| Zip Code | 63017-3451 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114549193 | Kathryn E Bos | Student in an Organized Health Care Education/Training Program | 873 Apt N Foxsprings Dr, Chesterfield, MO 63017 | 2020-05-12 |
| 1700415171 | Charles H. Edwards | Physical Therapist | 224 South Woods Millrd., Suite 610 South, Chesterfield, MO 63017 | 2020-04-07 |
| 1003454562 | Stephanie Henningsen | Physical Therapy Assistant | 307 S Woods Rd, Chesterfield, MO 63017 | 2019-12-16 |
| 1831746296 | Star Lynn Sutton | Occupational Therapy Assistant | 15207 Olive Boulevard, Chesterfield, MO 63017 | 2019-08-21 |
| 1639738438 | Van Amburg & Busiek Md's, LLC | Pharmacy | 232 S Woodsmill Road, Suite 330 East, Chesterfield, MO 63017 | 2019-06-06 |
| 1306306865 | Margaret Mary Wynn | Nurse Practitioner | 15740 South Outer Road, Chesterfield, MO 63017 | 2019-03-21 |
| 1205393089 | Kimberly Danielle | Nurse Practitioner | 744 Forest Trace Dr, Chesterfield, MO 63017 | 2019-02-27 |
| 1457823965 | Allison Joy Mcgrail | Dietitian, Registered | 45740 S Outer Forty Rd, Chesterfield, MO 63017 | 2018-12-21 |
| 1316418080 | Julie Lefere | Social Worker | Mercy Virtual Care Center, 15740 S Outer 40 Rd, Chesterfield, MO 63017 | 2018-12-06 |
| 1336629641 | Catherine Dolphin Smith | Nurse Practitioner | 224 S Woods Mill Rd Ste 500, Chesterfield, MO 63017 | 2018-08-16 |
| Find all providers in zip 63017 | ||||
| Taxonomy Code | 2080P0206X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Gastroenterology |
| A pediatrician who specializes in the diagnosis and treatment of diseases of the digestive systems of infants, children and adolescents. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using lighted scopes to see internal organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003383258 | Jose J. Derdoy, Md, LLC | Pediatrics | 845 N New Ballas Ct Ste 330, Creve Coeur, MO 63141-7169 | 2018-10-25 |
| 1366920118 | Danielle Marie Kenner | Pediatrics | 615 S New Ballas Rd Ste Yg230, Saint Louis, MO 63141-8221 | 2018-08-03 |
| 1366550261 | Jose Lorenzo Tirol Cocjin | Pediatrics | 2401 Gilham Rd Children's Mercy Hospitals and Clinic, Pediatric Gastroenterology, Kansas City, MO 64108 | 2006-08-29 |
| 1952361081 | David Richard Fleisher | Pediatrics | University of Missouri School of Medicine, Dept of Child Health. 1 Hospital Drive, Columbia, MO 65212 | 2006-03-24 |
| 1235510900 | Panamdeep Kaur | Pediatrics | 2401 Gillham Rd, Kansas City, MO 64108 | 2015-06-17 |
| 1194089557 | Roopali Mittal | Pediatrics | 404 N Keene St, Columbia, MO 65201 | 2012-06-30 |
| 1467747659 | Fernando Rafael Medina Carbonell | Pediatrics | 1465 S Grand Blvd, Saint Louis, MO 63104-1003 | 2011-06-15 |
| 1255622452 | Nadia Ibrahimi | Pediatrics | 2401 Gillham Rd, Kansas City, MO 64108-4619 | 2011-04-22 |
| 1689986382 | Rachel Kassel | Pediatrics | 1 Childrens Pl # 3s34, Saint Louis, MO 63110-1002 | 2010-07-09 |
| 1356652606 | Abhishek Watts | Pediatrics | 1965 S Fremont Ave, Suite 220, Springfield, MO 65804-2201 | 2010-07-01 |
| Find all providers with the same taxonomy | ||||
| City | CHESTERFIELD |
| Zip Code | 63017 |
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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.