TIMOTHY MANUEL (NPI# 1689652158) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689652158 |
| Entity Type | Individual |
| Full Name | TIMOTHY MANUEL |
| Credential | M.D. |
| Practice Address |
13065 Old Tesson Ferry Rd Saint Louis MO 63128-3441 |
| Mailing Address |
Po Box 14222 Belfast ME 04915-4035 |
| Practice Telephone | 3146479797 |
| Practice Fax Number | 3142708520 |
| Mailing Telephone | 3146479797 |
| Enumeration Date | 2006-01-05 |
| Last Update Date | 2016-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208D00000X | General Practice | 35-065764 | OH | Allopathic & Osteopathic Physicians |
| Y | 208D00000X | General Practice | 2016016256 | MO | Allopathic & Osteopathic Physicians |
| Street Address |
13065 OLD TESSON FERRY RD |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63128-3441 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154773455 | Alicia Perry | Nurse Practitioner | 13065 Old Tesson Ferry Rd, Saint Louis, MO 63128-3441 | 2016-07-11 |
| 1154556363 | Bam Urgent Care LLC | Clinic/Center | 13065 Old Tesson Ferry Rd, Saint Louis, MO 63128-3441 | 2009-05-18 |
| 1952436792 | Diane M Rup | Pediatrics | 13065 Old Tesson Ferry Rd, Saint Louis, MO 63128-3441 | 2007-02-22 |
| 1770692048 | Theresa Lee Mcquaide | Registered Nurse | 13065 Old Tesson Ferry Rd, Saint Louis, MO 63128-3441 | 2006-08-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235771155 | James T Fetsch Dmd LLC | Dentist | 10004 Kennerly Rd Suite 240, Saint Louis, MO 63128 | 2019-10-11 |
| 1326504655 | Nikodem Dental Holdings | Dentist | 4337 Butler Hill Rd Suite G, St Louis Mo, MO 63128 | 2019-02-12 |
| 1932678505 | Michelle Anne Arvidson | Physical Therapy Assistant | Elite Physical Therapy, 12608 Lamplighter Square Shopping Center, St. Louis, MO 63128 | 2018-11-13 |
| 1245726710 | Kristen Rider | Nurse Practitioner | 9964 Kennerly Rd Ste D, Saint Louis, MO 63128 | 2018-07-07 |
| 1306217427 | Sophia Bednarski | Dentist | 12660 Lamplighter Square Shopping Center, St. Louis, MO 63128 | 2015-10-15 |
| 1427434224 | Darcie Burrus | Counselor | 12523 Old Tesson Rd G, St Louis, MO 63128 | 2015-08-04 |
| 1710368584 | Sara Hawatmeh | Internal Medicine | 12345 W Bend Dr Ste 304, Saint Louis, MO 63128 | 2015-06-17 |
| 1871989590 | Celia Grace Montes-kolence | Speech-Language Pathologist | 12335 W Bend Drive, Saint Louis, MO 63128 | 2015-04-09 |
| 1245629302 | Marius Antonio Evans | Dentist | 9911 Kennerly Rd., Suite G, St. Louis, MO 63128 | 2015-01-13 |
| 1801230313 | Sarah Elizabeth Walsh | Emergency Medicine | 10010 Kennerly Road, Emergency Department, St. Anthony's Medical Center, St. Louis, MO 63128 | 2013-04-26 |
| Find all providers in zip 63128 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790205854 | Zachary Avital Goodman | General Practice | 6642 Clayton Rd # 278, Saint Louis, MO 63117-1602 | 2017-06-20 |
| 1174926224 | Anita Dewan | General Practice | 9917 Grandview Forest Ct, Saint Louis, MO 63127-0046 | 2014-10-03 |
| 1356755201 | Jessica Ellie Ma | General Practice | 216 S Kingshighway Blvd Fl 6, 6th Floor, Saint Louis, MO 63110-1026 | 2014-06-19 |
| 1235550385 | Doctor's On The Way, Inc | General Practice | 712 N 2nd St, Ste 310, Saint Louis, MO 63102-2550 | 2013-12-16 |
| 1518398916 | John Allen Cooper | General Practice | 40 N Kingshighway Blvd Apt 13f, Saint Louis, MO 63108-1343 | 2013-12-10 |
| 1417382821 | Hyung T Kim | General Practice | 11 Crestwood Dr, Saint Louis, MO 63105-3032 | 2013-09-05 |
| 1356617443 | Kirsten Frances Dunn | General Practice | 1040 N Mason Rd Ste 103, Ste 103, Saint Louis, MO 63141-6361 | 2012-03-22 |
| 1902199623 | Care Plus Medical Group LLC | General Practice | 10650 Gateway Blvd, Saint Louis, MO 63132-1802 | 2011-05-27 |
| 1437474202 | Debra Lynne Moss | General Practice | 12929 Ballantine Ct, Saint Louis, MO 63146-3701 | 2010-04-05 |
| 1558538850 | Patrice Lynn Wakefield | General Practice | 514 Donne Ave, Saint Louis, MO 63130-3918 | 2008-05-15 |
| Find all providers in SAINT LOUIS | ||||
| City | SAINT LOUIS |
| Zip Code | 63128 |
Please comment or provide details below to improve the information on TIMOTHY MANUEL.
| 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.