DR. MITCHELL N FADDIS (NPI# 1740206044) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740206044 |
| Entity Type | Individual |
| Full Name | DR. MITCHELL N FADDIS |
| Credential | MD |
| Practice Address |
216 S Kingshighway Blvd North Campus Cardiology Center Saint Louis MO 63110-1026 |
| Mailing Address |
660 S Euclid Ave C B 8086 Saint Louis MO 63110-1010 |
| Practice Telephone | 3144547450 |
| Practice Fax Number | 3144548250 |
| Mailing Telephone | 3144547450 |
| Mailing Fax Number | 3144548250 |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2018-01-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | 103760 | MO | Allopathic & Osteopathic Physicians |
| N | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
103760 | MO | Allopathic & Osteopathic Physicians |
| Y | 207RC0001X |
Internal Medicine Specialization: Clinical Cardiac Electrophysiology |
103760 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 203855606 | 05 | |
| IL | ENROLLED | 05 |
| Street Address |
216 S KINGSHIGHWAY BLVD NORTH CAMPUS CARDIOLOGY CENTER |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63110-1026 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598769986 | Donald Craig Allred | Pathology | 216 S Kingshighway Blvd, Saint Louis, MO 63110-1026 | 2005-06-13 |
| 1457832404 | Sudhir Bhimaniya | Radiology | 216 S Kingshighway Blvd, Saint Louis, MO 63110-1026 | 2018-08-28 |
| 1164926846 | Anup K. Bhattacharya | Student in an Organized Health Care Education/Training Program | 216 S Kingshighway Blvd, Saint Louis, MO 63110-1026 | 2018-03-19 |
| 1902349947 | Rebecca Jo Petersen | Nurse Practitioner | 216 S Kingshighway Blvd, Saint Louis, MO 63110-1026 | 2016-11-23 |
| 1467811893 | Kathleen Dienst Stockmann | Dietitian, Registered | 216 S Kingshighway Blvd, Mailstop 90-32-612, Saint Louis, MO 63110-1026 | 2016-02-12 |
| 1770941775 | Gina Jorel | Dietitian, Registered | 216 S Kingshighway Blvd, Mailstop: 90-32-612, Saint Louis, MO 63110-1026 | 2016-02-04 |
| 1508224676 | Kayli Hemphill | Dietitian, Registered | 216 S Kingshighway Blvd, Mailstop 90-32-612, Saint Louis, MO 63110-1026 | 2016-02-04 |
| 1912389404 | Ann-marcia Comfort Tukpah | General Practice | 216 S Kingshighway Blvd, 6th Fl, Saint Louis, MO 63110-1026 | 2015-06-22 |
| 1750787289 | Andrea Mcdonald | Nurse Practitioner | 216 S Kingshighway Blvd, Cancer Care Clinic, Saint Louis, MO 63110-1026 | 2014-11-11 |
| 1578977963 | Jacqueline Wenjia Chen | General Practice | 216 S Kingshighway Blvd, Saint Louis, MO 63110-1026 | 2014-06-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659971992 | Carrie Ellen Smith | Nurse Practitioner | Mailstop 90-00-174, One Barnes-jewish Plaza, St. Louis, MO 63110 | 2020-10-27 |
| 1881210466 | Michelle Amanda Freilich | Internal Medicine | Barnes-jewish Plaza, St. Louis, MO 63110 | 2020-06-19 |
| 1245856046 | Jeevin Shahi | Radiology | 3685 Vista Avenue, Center for Radiation Medicine, St. Louis, MO 63110 | 2020-06-18 |
| 1497371314 | Wilson Eduardo Rodriguez | Student in an Organized Health Care Education/Training Program | 1008 S. Spring, St Louis, MO 63110 | 2020-06-17 |
| 1578184065 | Kathryn Kay Lindsay | Registered Nurse | Saint Louis University Dept of Surgery, 3635 Vista Ave 3dt, St Louis, MO 63110 | 2020-05-06 |
| 1881232700 | Ashley Diane Pace | Nurse Practitioner | 1 Parkview Place, Shoenberg 6900, St. Louis, MO 63110 | 2019-12-11 |
| 1619520418 | Krithika Damodar Shenoy | Pathology | 660 Euclid Avenue, One Barnes Jewish Hospital Plaza, St. Louis, MO 63110 | 2019-07-20 |
| 1467912550 | Ian Ferguson | Dermatology | 660 S Euclid Ave., Cb 8123, St. Louis, MO 63110 | 2019-03-23 |
| 1760978688 | Ihab Hassanieh | Student in an Organized Health Care Education/Training Program | 33660 Vista Ave, St. Louis, MO 63110 | 2018-07-03 |
| 1336634500 | Martin K Mwangi | Pediatrics | 1 Childrens Place, 3s34, St. Louis, M, MO 63110 | 2018-06-28 |
| Find all providers in zip 63110 | ||||
| Taxonomy Code | 207RC0001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Clinical Cardiac Electrophysiology |
| A field of special interest within the subspecialty of cardiovascular disease, specialty of Internal Medicine, which involves intricate technical procedures to evaluate heart rhythms and determine appropriate treatment for them. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366451635 | Eric S Williams | Internal Medicine | 625 S New Ballas Rd Ste 2030, Saint Louis, MO 63141-8253 | 2006-08-05 |
| 1164726758 | The Heart Specialty Associates, LLC | Internal Medicine | 10012 Kennerly Rd Ste 403, Saint Louis, MO 63128-2197 | 2010-12-22 |
| 1093770257 | Ali Akbar Mehdirad | Internal Medicine | 777 S New Ballas Rd, Suite 300e, Saint Louis, MO 63141-8705 | 2006-04-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548214158 | John K Lee | Internal Medicine | 20 Ne Saint Luke's Blvd, Suite 240, Kansas City, MO 64086 | 2006-05-19 |
| 1205809175 | Carey S Fredman | Internal Medicine | 222 S Woods Mill Rd Ste 400n, Chesterfield, MO 63017-3610 | 2006-02-09 |
| 1629439187 | St. Louis Electrophysiology Specialists, LLC | Internal Medicine | 121 Saint Lukes Center Dr Ste 404, Chesterfield, MO 63017-3519 | 2016-03-11 |
| 1427449487 | Prime Healthcare Kansas City - Physician Services LLC | Internal Medicine | 930 Carondelet Dr Ste 201, Kansas City, MO 64114-4698 | 2015-02-12 |
| 1679836381 | Jefferson Cardiovascular and Thoracic Services | Internal Medicine | 1390 Us Highway 61, Suite 3301, Festus, MO 63028-4137 | 2012-06-18 |
| 1518280395 | Saint Luke's Physician Group I, LLC | Internal Medicine | 4330 Wornall Rd, Suite 2000, Kansas City, MO 64111-5939 | 2010-03-08 |
| 1356544993 | Aparna Cherla | Internal Medicine | 3800 S National Ave, Springfield, MO 65807-5209 | 2007-06-11 |
| 1104036029 | Jason Alan Rytlewski | Internal Medicine | 1605 East Broadway, #300, Columbia, MO 65201 | 2007-05-22 |
| 1093861601 | John Brian Garner | Internal Medicine | 3800 S National Ave, Suite 400, Springfield, MO 65807-5209 | 2007-01-26 |
| 1891866018 | Alan P Wimmer | Internal Medicine | 4330 Wornall Rd, Suite 2000, Kansas City, MO 64111-5939 | 2006-11-10 |
| Find all providers with the same taxonomy | ||||
| City | SAINT LOUIS |
| Zip Code | 63110 |
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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.