SPINE CIN OF ST LOUIS LLC (NPI# 1689173692) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689173692 |
| Entity Type | Organization |
| Organization Name | SPINE CIN OF ST LOUIS LLC |
| Practice Address |
11628 Old Ballas Rd # 344 Saint Louis MO 63141-7030 |
| Mailing Address |
102 Woodmont Blvd Ste 350 Nashville TN 37205-2216 |
| Practice Telephone | 6153860064 |
| Practice Fax Number | 6153860067 |
| Mailing Telephone | 6153860064 |
| Mailing Fax Number | 6153860067 |
| Enumeration Date | 2018-02-05 |
| Last Update Date | 2018-02-05 |
| Authorized Official Name | EDWARD LELAND HUTTON EADIE (DIRECTOR) |
| Authorized Official Telephone | 6157332064 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207XS0117X |
Orthopaedic Surgery Specialization: Orthopaedic Surgery of the Spine |
MO | Allopathic & Osteopathic Physicians | |
| Y | 207X00000X | Orthopaedic Surgery | MO | Allopathic & Osteopathic Physicians |
| Street Address |
11628 OLD BALLAS RD # 344 |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63141-7030 |
| 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 | 207X00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760903850 | Adam J Martin | Orthopaedic Surgery | 621 S New Ballas Rd Ste 3005b, Saint Louis, MO 63141-8266 | 2017-06-29 |
| 1801254164 | St. Anthony's Physician Organization | Orthopaedic Surgery | 12700 Southfork Rd Ste 100, Saint Louis, MO 63128-3201 | 2016-02-02 |
| 1285051482 | Michael Joseph Reiter | Orthopaedic Surgery | 3009 N Ballas Rd Ste 269c, Saint Louis, MO 63131-2339 | 2014-03-25 |
| 1154767507 | Robert M Corey | Orthopaedic Surgery | 3635 Vista Ave, 7th Floor- Desloge Tower, Department of Orthopedics, Saint Louis, MO 63110 | 2013-05-13 |
| 1770855884 | George Owens Sertl | Orthopaedic Surgery | 10757 Forest Path Dr, Saint Louis, MO 63128-2008 | 2012-02-04 |
| 1285881581 | John Powell Arnot | Orthopaedic Surgery | 1145 Lockett Rd, Saint Louis, MO 63131-4234 | 2008-08-19 |
| 1558526327 | Jordan Howard Ginsburg | Orthopaedic Surgery | 231 S Bemiston Ave, Suite 500, Saint Louis, MO 63105-1914 | 2008-07-22 |
| 1659562528 | Kenyatta D Norman | Orthopaedic Surgery | 1209 Washington Ave, Ste 518, Saint Louis, MO 63103-1996 | 2007-08-06 |
| 1134342918 | Matthew Walter Bradley | Orthopaedic Surgery | 1001 S Kirkwood Rd Ste 120, Saint Louis, MO 63122-7250 | 2007-04-10 |
| 1437272663 | St. Louis-clayton Orthopedic Group, Inc. | Orthopaedic Surgery | 1034 S Brentwood Blvd Ste 650, Saint Louis, MO 63117-1267 | 2007-04-10 |
| Find all providers in SAINT LOUIS | ||||
| City | SAINT LOUIS |
| Zip Code | 63141 |
Please comment or provide details below to improve the information on SPINE CIN OF ST LOUIS LLC.
| 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.