DR. JOHN EDWIN KRETTEK JR. (NPI# 1699855577) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699855577 |
| Entity Type | Individual |
| Full Name | DR. JOHN EDWIN KRETTEK JR. |
| Credential | M.D> |
| Practice Address |
3015 N Ballas Rd Saint Louis MO 63131-2329 |
| Mailing Address |
12840 W Watson Rd Saint Louis MO 63127-1539 |
| Practice Telephone | 3149965004 |
| Mailing Telephone | 3148437784 |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207T00000X | Neurological Surgery | R2F39 | MO | Allopathic & Osteopathic Physicians |
| Street Address |
3015 N BALLAS RD |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63131-2329 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861497604 | Allen D Baudendistel | Anesthesiology | 3015 N Ballas Rd, Saint Louis, MO 63131-2329 | 2005-06-17 |
| 1790392991 | Jessica E. Steffens | Advanced Practice Midwife | 3015 N Ballas Rd, Saint Louis, MO 63131-2329 | 2020-09-30 |
| 1780298711 | Courtney Mcghee | Pharmacist | 3015 N Ballas Rd, Saint Louis, MO 63131-2329 | 2020-09-08 |
| 1568074466 | Stephanie Chen | Pharmacist | 3015 N Ballas Rd, Saint Louis, MO 63131-2329 | 2020-08-20 |
| 1720696628 | Missouri Baptist Medical Center | Clinical Medical Laboratory | 3015 N Ballas Rd, Saint Louis, MO 63131-2329 | 2020-07-16 |
| 1952928665 | Rebecca Goodwillie | Nurse Practitioner | 3015 N Ballas Rd, Saint Louis, MO 63131-2329 | 2020-06-29 |
| 1487275160 | Emily Beth Anderson | Registered Nurse | 3015 N Ballas Rd, Saint Louis, MO 63131-2329 | 2020-05-04 |
| 1144841461 | Demitra Marie Nichoalds | Registered Nurse | 3015 N Ballas Rd, Saint Louis, MO 63131-2329 | 2020-04-27 |
| 1992334676 | Brian Christopher Ritter | Registered Nurse | 3015 N Ballas Rd, Saint Louis, MO 63131-2329 | 2020-04-05 |
| 1851927180 | Laura Beth Mulcahy | Midwife | 3015 N Ballas Rd, Saint Louis, MO 63131-2329 | 2020-03-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568097954 | Avalcare Inc | Pharmacy | 10431 Clayton Rd, Saint Louis, MO 63131 | 2020-03-06 |
| 1891331369 | Life Clinic of Mo Dc PC | Chiropractor | 2051 South Lindbergh Blvd, Frontenac, MO 63131 | 2019-11-20 |
| 1447892542 | Jand. Inc. | Eyewear Supplier (Equipment, not the service) | 30 S Lindbergh Blvd, Saint Louis, MO 63131 | 2019-10-10 |
| 1336797026 | Justa Davis | Dietitian, Registered | 3015 North Ballas, Saint Louis, MO 63131 | 2019-08-27 |
| 1730695362 | Curators of The University of Missouri | Psychologist | 12837 Flushing Meadows Drive, Sutie 220, Town and Country, MO 63131 | 2017-12-19 |
| 1770012031 | Danielle Marie Hargate | Specialist/Technologist | 732 Timber Trail, Frontenac, MO 63131 | 2017-06-08 |
| 1285087429 | Kathryn Parker | Internal Medicine | 1000 Des Peres Rd Ste 300, Saint Louis, MO 63131 | 2016-07-22 |
| 1437524360 | Julie Ann Godefroid | Nurse Practitioner | 1010 Old Des Peres Road, St. Louis, MO 63131 | 2015-12-03 |
| 1073982435 | Rebecca Baum Rainbolt | Social Worker | 12210 Clayton Rd, Saint Louis, MO 63131 | 2015-09-16 |
| 1518217322 | Advanced Anesthesia and Pain Management, LLC | Anesthesiology | 12805 Topping Woods Estate Drive, St. Louis, MO 63131 | 2012-09-19 |
| Find all providers in zip 63131 | ||||
| Taxonomy Code | 207T00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Neurological Surgery |
| A neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify function or activity of the nervous system; and the operative and non-operative management of pain. A neurological surgeon treats patients with disorders of the nervous system; disorders of the brain, meninges, skull, and their blood supply, including the extracranial carotid and vertebral arteries; disorders of the pituitary gland; disorders of the spinal cord, meninges, and vertebral column, including those which may require treatment by spinal fusion or instrumentation; and disorders of the cranial and spinal nerves throughout their distribution. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Neurological Surgery, 2007. http://www.abns.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Neurological Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912276486 | Paul Edward Stohr | Neurological Surgery | 2 Kirken Knoll Dr, Saint Louis, MO 63131-2310 | 2011-12-29 |
| 1275801896 | George Emanuel Mendelsohn | Neurological Surgery | 24 Loren Woods, Saint Louis, MO 63124-1903 | 2011-12-09 |
| 1770802076 | Aneela Darbar | Neurological Surgery | 3635 Vista Ave, Grand Blvd, Saint Louis, MO 63110-0250 | 2010-05-26 |
| 1386850881 | David D Limbrick Jr. | Neurological Surgery | 1 Childrens Pl Ste 4e, Ste 4e, Saint Louis, MO 63110-1002 | 2007-05-14 |
| 1376560805 | Tae Sung Park | Neurological Surgery | 1 Childrens Pl Fl 1, 1st Fl, Saint Louis, MO 63110-1002 | 2006-07-17 |
| 1841218278 | Matthew D Smyth | Neurological Surgery | 1 Childrens Pl Ste 4s20, Ste 4s20, Saint Louis, MO 63110-1002 | 2006-07-17 |
| 1265420269 | Robert J Bernardi IIi | Neurological Surgery | 11605 Studt Ave, Suite One, Saint Louis, MO 63141-7052 | 2005-10-12 |
| 1457351926 | Gregory Joseph Bailey | Neurological Surgery | 1035 Bellevue Ave Ste 500, Saint Louis, MO 63117-1843 | 2005-07-27 |
| 1326048935 | Charles A Wetherington | Neurological Surgery | 6725 Chippewa St, Saint Louis, MO 63109-2534 | 2005-07-26 |
| 1306846928 | Armond L Levy | Neurological Surgery | 13625 Big Bend Rd, Saint Louis, MO 63122-3915 | 2005-07-26 |
| Find all providers in SAINT LOUIS | ||||
| City | SAINT LOUIS |
| Zip Code | 63131 |
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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.