MERCY CLINIC EAST COMMUNITIES (NPI# 1720635329) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1720635329 |
Entity Type | Organization |
Organization Name | MERCY CLINIC EAST COMMUNITIES |
Practice Address |
10004 Kennerly Rd Ste 395b Saint Louis MO 63128-2190 |
Mailing Address |
Po Box 776084 Chicago IL 60677-6084 |
Practice Telephone | 3148493500 |
Practice Fax Number | 3145435951 |
Mailing Telephone | 3143644347 |
Enumeration Date | 2019-08-20 |
Last Update Date | 2019-08-20 |
Authorized Official Name | CHERYL MATEJKA (CFO) |
Authorized Official Telephone | 3142511958 |
Is Organization Subpart | Y |
Parent Organization Name | MERCY CLINIC EAST COMMUNITIES |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1164857397 | Mercy Clinic East Communities | Clinic/Center | 16555 Manchester Rd Ste 110, Wildwood, MO 63040-1220 | 2013-09-06 |
1235493776 | Mercy Clinic East Communities | Clinic/Center | 125 N Old Highway 66, Bourbon, MO 65441-6298 | 2012-06-29 |
1700370061 | Mercy Clinic East Communities | Internal Medicine | 15945 Clayton Rd Ste 310, Ballwin, MO 63011-2493 | 2018-06-20 |
1285998724 | Mercy Clinic East Communities | Clinic/Center | 301 Theresa St, Cuba, MO 65453-1636 | 2012-06-29 |
1467716928 | Mercy Clinic East Communities | Clinic/Center | 101 Progress Pkwy, Sullivan, MO 63080-2359 | 2012-06-29 |
1619231164 | Mercy Clinic East Communities | Clinic/Center | 520 Pine St, Steelville, MO 65565-6041 | 2012-06-29 |
1043574940 | Mercy Clinic East Communities | Allergy & Immunology | 615 S New Ballas Rd, Administration Building, 5th Floor, Saint Louis, MO 63141-8221 | 2012-06-26 |
1073739041 | Mercy Clinic East Communities | Family Medicine | 615 S New Ballas Rd, Administrative Building, 5th Floor, Saint Louis, MO 63141-8221 | 2007-04-18 |
1851335228 | Mercy Clinic East Communities | Family Medicine | 615 S New Ballas Rd, Administration Building, 5th Floor, Saint Louis, MO 63141-8221 | 2006-06-16 |
Entity Type | Entity Name | Entity Address |
---|---|---|
System for Award Management (SAM) Entities | MERCY CLINIC EAST COMMUNITIES | 645 Maryville Centre Dr, Saint Louis, MO 63141-5855 |
Street Address |
10004 KENNERLY RD STE 395B |
City | SAINT LOUIS |
State | MO |
Zip Code | 63128-2190 |
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 | 207Q00000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Family Medicine |
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1356986541 | Pain Relief Center of St Louis LLC | Family Medicine | 1115 Olivette Executive Pkwy, Saint Louis, MO 63132-3259 | 2019-11-12 |
1063066777 | Isabella Citizens for Health, Inc. | Family Medicine | 312 Union St, Saint Louis, MI 48880-1830 | 2019-07-31 |
1043864010 | Isabella Citizens for Health, Inc. | Family Medicine | 113 E Saginaw St, Saint Louis, MI 48880-1755 | 2019-07-29 |
1558896969 | Shivani Sockanathan | Family Medicine | 969 N Mason Rd Ste 145a, Saint Louis, MO 63141-6282 | 2017-04-23 |
1598299646 | Kharole Compere | Family Medicine | 175 N Oaks Plz, Saint Louis, MO 63121-2925 | 2017-04-16 |
1396109880 | Ritesh Gandhi | Family Medicine | 7345 Watson Rd Ste 203, Saint Louis, MO 63119 | 2016-04-11 |
1144608035 | Daniel Urcuyo | Family Medicine | 4625 Lindell Blvd Ste 338, Saint Louis, MO 63108 | 2015-05-11 |
1376958728 | Jamil Neme | Family Medicine | 3660 Vista Ave Ste 103, Saint Louis, MO 63110-2540 | 2014-06-24 |
1144633819 | Perini Shah | Family Medicine | 12700 Southfork Rd Ste 215, Saint Louis, MO 63128-3276 | 2014-06-10 |
1982017786 | Alexander John Mazzaferro | Family Medicine | 4280 Mid America Ln Ste 30, Saint Louis, MO 63129-1202 | 2014-06-09 |
Find all providers in SAINT LOUIS |
City | SAINT LOUIS |
Zip Code | 63128 |
Please comment or provide details below to improve the information on MERCY CLINIC EAST COMMUNITIES.
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.