VEIN SPECIALTIES AND MEDI-SPA, LLC (NPI# 1730540196) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730540196 |
| Entity Type | Organization |
| Organization Name | VEIN SPECIALTIES AND MEDI-SPA, LLC |
| Other Organization Name | MIDWEST VASCULAR & ENDOVASCULAR SURGERY |
| Practice Address |
1035 Bellevue Ave Ste 212 Saint Louis MO 63117-1846 |
| Mailing Address |
8 Jaccard Ln Saint Louis MO 63131-2627 |
| Practice Telephone | 3142878080 |
| Mailing Telephone | 3144886283 |
| Enumeration Date | 2016-03-14 |
| Last Update Date | 2019-10-02 |
| Authorized Official Name | MS. MARGARET MARY RIMEL (PRACTICE ADMINISTRATOR) |
| Authorized Official Telephone | 3142878080 |
| Authorized Official Credential | MBA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM2500X |
Clinic/Center Specialization: Medical Specialty |
108988 | MO | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Midwest Vascular & Endovascular Surgery | Former Legal Business Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 8 Jaccard Ln, Saint Louis, MO 631312627 | 3144886283 |
| Street Address |
1035 BELLEVUE AVE STE 212 |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63117-1846 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518992429 | Ayaz A Malik | Surgery | 1035 Bellevue Ave Ste 212, Saint Louis, MO 63117-1846 | 2006-07-11 |
| 1073718409 | Rachael Damask Brewer | Registered Nurse | 1035 Bellevue Ave Ste 212, Saint Louis, MO 63117-1846 | 2007-06-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255956611 | Efehi Kelly Ogbomo | Student in an Organized Health Care Education/Training Program | 6420 Clayton Rd, Suite 2218, St. Louis, MO 63117 | 2020-06-11 |
| 1619533890 | Abdul Rauf | Student in an Organized Health Care Education/Training Program | 6420 Clayton Road. Ssm Health St. Mary's Hospital, St. Louis, MO 63117 | 2019-05-14 |
| 1083278477 | Mohamed Maali Gumaa Mohamed | Student in an Organized Health Care Education/Training Program | 6420 Clayton Road Ssm St. Mary's Hospital, Department of Internal Medicine, St. Louis, MO 63117 | 2019-05-01 |
| 1750945556 | Samrat Jun Jayanth | Student in an Organized Health Care Education/Training Program | 6420 Clayton Road, Ssm Health St Mary's Hospital, St. Louis, MO 63117 | 2019-04-26 |
| 1215491329 | Latonya Allen | Counselor | 1612 S. Big Bend Blvd, St. Louis, MO 63117 | 2019-01-23 |
| 1265917025 | Blue Stars Therapy, LLC | Occupational Therapist | 1101 Edward Terrace, Apt A, St. Louis, MO 63117 | 2018-09-27 |
| 1770060014 | Ultra Care Home Services LLC | Home Health | 7353 Dale Ave, Saint Louis, MO 63117 | 2018-07-19 |
| 1235623562 | Melissa Valerie Taylor | Counselor | Psychological Services of St Louis, LLC, 7110 Oakland Ave, St Louis, MO 63117 | 2018-06-20 |
| 1124517289 | Jideofor Ebony Obodozie | Student in an Organized Health Care Education/Training Program | 6420 Clayton Road, Ssm St. Mary's Hospital, St. Louis, MO 63117 | 2018-05-04 |
| 1770071706 | Sivaram Prabhuji Muppaneni | Student in an Organized Health Care Education/Training Program | Ssm St Mary's Hospital, 6420 Clayton Road, St. Louis, MO 63117 | 2018-04-25 |
| Find all providers in zip 63117 | ||||
| Taxonomy Code | 261QM2500X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Medical Specialty |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871044735 | Susan D Purcell Md Dermatology LLC | Clinic/Center | 969 N Mason Rd Ste 170, Saint Louis, MO 63141-6387 | 2016-10-16 |
| 1154730414 | Mohammed Z Siddiqui Medical Consulting LLC | Clinic/Center | 10 Overbrook Dr, Saint Louis, MO 63124-1482 | 2014-08-11 |
| 1376875393 | Ballas Chiropractic Centre Inc | Clinic/Center | 11639 Studt Ave, Saint Louis, MO 63141-7015 | 2010-02-01 |
| 1285664268 | Physician Groups Lc | Clinic/Center | 670 Mason Ridge Center Dr, Suite 300, Saint Louis, MO 63141-8573 | 2006-07-04 |
| 1437185782 | Missouri Cvs Pharmacy, L.L.C. | Clinic/Center | 6600 Clayton Rd, Saint Louis, MO 63117-1602 | 2006-06-25 |
| 1104861129 | Missouri Cvs Pharmacy, L.L.C. | Clinic/Center | 10650 Olive Blvd, Saint Louis, MO 63141-7834 | 2006-06-17 |
| 1114344348 | St Louis Kidney, LLC | Clinic/Center | 12855 N 40 Dr, Suite 205, Saint Louis, MO 63141-8657 | 2014-03-26 |
| 1003246026 | True Results Missouri, LLC | Clinic/Center | 12855 N 40 Dr, Suite 275, Saint Louis, MO 63141-8657 | 2013-11-13 |
| 1811268428 | Joseph M Seria Md LLC | Clinic/Center | 3915 Watson Rd, Suite 204, Saint Louis, MO 63109-1251 | 2012-01-13 |
| 1346576709 | The Youthful Body, Inc. | Clinic/Center | 10287 Clayton Rd, Suite 200, Saint Louis, MO 63124-1172 | 2009-10-20 |
| Find all providers in SAINT LOUIS | ||||
| City | SAINT LOUIS |
| Zip Code | 63117 |
Please comment or provide details below to improve the information on VEIN SPECIALTIES AND MEDI-SPA, 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.