ST. JOHN'S PEDIATRIC SERVICES (NPI# 1679876734) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679876734 |
| Entity Type | Organization |
| Organization Name | ST. JOHN'S PEDIATRIC SERVICES |
| Practice Address |
621 S New Ballas Rd # 2003b Saint Louis MO 63141-8232 |
| Practice Telephone | 3142516299 |
| Mailing Telephone | 3142516299 |
| Enumeration Date | 2010-12-13 |
| Last Update Date | 2010-12-13 |
| Authorized Official Name | DR. JOESPH KAHN (DEPARTMENT CHAIRMAN/SUPERVISOR) |
| Authorized Official Telephone | 3142516299 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 282NC2000X |
General Acute Care Hospital Specialization: Children |
2010034857 | MO | Hospitals |
| Street Address |
621 S NEW BALLAS RD # 2003B |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63141-8232 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790788941 | Robert J Backer | Specialist | 621 S New Ballas Rd, Ste 297a, Saint Louis, MO 63141-8232 | 2005-05-23 |
| 1609362474 | Manesh Kumar Gangwani | Internal Medicine | 621 S New Ballas Rd, Saint Louis, MO 63141-8232 | 2018-07-05 |
| 1164918165 | Ayesha Farrukh | Internal Medicine | 621 S New Ballas Rd, Saint Louis, MO 63141-8232 | 2018-07-03 |
| 1720573769 | Chelsea Renee Drissell | Family Medicine | 621 S New Ballas Rd, Saint Louis, MO 63141 | 2018-06-22 |
| 1023502358 | Bryan Gabriel Acree | Internal Medicine | 621 S New Ballas Rd, Saint Louis, MO 63141-8232 | 2018-06-20 |
| 1700370996 | Kathryn Emily Harvey-feldewerth | Internal Medicine | 621 S New Ballas Rd, Saint Louis, MO 63141-8232 | 2018-06-20 |
| 1063906493 | Paul Pearson Panasiuk | Obstetrics & Gynecology | 621 S New Ballas Rd, Saint Louis, MO 63141-8232 | 2018-06-19 |
| 1558855056 | Jessica Jenkins | Obstetrics & Gynecology | 621 S New Ballas Rd, Saint Louis, MO 63141-8232 | 2018-06-18 |
| 1679067276 | Kristopher Vaughn Pullam | Family Medicine | 621 S New Ballas Rd, Saint Louis, MO 63141-8232 | 2018-06-18 |
| 1932693629 | Lawrence Andrew Rudolf | Family Medicine | 621 S New Ballas Rd, Saint Louis, MO 63141-8232 | 2018-06-18 |
| 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 | 282NC2000X |
| Grouping | Hospitals |
| Classification | General Acute Care Hospital |
| Specialization | Children |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518425289 | St Louis Children's Hospital | General Acute Care Hospital | 1 Childrens Pl, Saint Louis, MO 63110-1002 | 2019-03-12 |
| 1528375417 | Saint Louis Childrens Hospital | General Acute Care Hospital | 1 Childrens Pl, Saint Louis, MO 63110-1002 | 2010-09-13 |
| 1699087601 | Ssm Cardinal Glennon Children's Hospital | General Acute Care Hospital | 1465 S Grand Blvd, Diet Office, Saint Louis, MO 63104-1003 | 2010-07-07 |
| 1508181777 | St. Louis Children's Hospital | General Acute Care Hospital | 1 Childrens Pl, Saint Louis, MO 63110-1002 | 2010-03-31 |
| 1699002527 | Cardinal Glennon Children's Hospital | General Acute Care Hospital | 1465 S Grand Blvd, Saint Louis, MO 63104-1003 | 2009-11-13 |
| 1255664645 | Ssm Cardinal Glennon Children's Medical Center | General Acute Care Hospital | 1465 S Grand Blvd, Saint Louis, MO 63104-1003 | 2009-09-16 |
| 1518181536 | St Louis Childrens Hospital | General Acute Care Hospital | 1465 S Grand Blvd, Saint Louis, MO 63104-1003 | 2007-04-12 |
| 1356462493 | St. John's Mercy Child Development Center | General Acute Care Hospital | 641 N New Ballas Rd, Saint Louis, MO 63141-6713 | 2007-04-03 |
| 1508935891 | Ssm Cardinal Glennon Children's Hospital | General Acute Care Hospital | 1465 S Grand Blvd, Saint Louis, MO 63104-1003 | 2006-11-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992183172 | Children's Mercy Hospital | General Acute Care Hospital | 2401 Gillham Rd, Kansas City, MO 64108-4619 | 2015-05-08 |
| 1669899639 | Ricole Shafer | General Acute Care Hospital | 2401 Gillham Rd, Kansas City, MO 64108-4619 | 2014-03-27 |
| 1417299157 | Pediatrix | General Acute Care Hospital | 4401 Wornall Road, Saint Luke's Hospital, Kansas City, MO 64111 | 2013-03-20 |
| 1568723765 | Children's Mercy Hospitals & Clinics | General Acute Care Hospital | 2401 Gillham Rd, Kansas City, MO 64108-4619 | 2012-06-04 |
| 1346518016 | Children's Mercy Hospital | General Acute Care Hospital | 2401 Gillham Rd, Kansas City, MO 64108-4619 | 2011-12-08 |
| 1366751950 | The Children's Mercy Hospital | General Acute Care Hospital | 3101 Broadway St, Kansas City, MO 64111-2659 | 2010-09-29 |
| 1427386960 | Childrens Mercy Hospital | General Acute Care Hospital | 2401 Gillham Rd, Kansas City, MO 64108-4619 | 2009-11-20 |
| 1063535581 | Anne Clair Bisch | General Acute Care Hospital | 3165 Mckelvey Rd, Suite 110, Bridgeton, MO 63044-2550 | 2007-04-09 |
| 1942343447 | Shriners Hospitals for Children | General Acute Care Hospital | 4400 Clayton Avenue, St. Louis, MO 63110-1624 | 2007-02-14 |
| 1366515488 | Children's Mercy Hospital | General Acute Care Hospital | 2401 Gillham Rd, Kansas City, MO 64108-4619 | 2006-11-16 |
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| 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.