DR. MITCHELL N FADDIS


Address: 216 S Kingshighway Blvd, North Campus Cardiology Center, Saint Louis, MO 63110-1026
Phone: 3144547450

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).

Provider Overview

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

Taxonomy

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

Other Provider Identifier

State Issuer Identifier Type Code
MO 203855606 05
IL ENROLLED 05

Office Location

Street Address 216 S KINGSHIGHWAY BLVD
NORTH CAMPUS CARDIOLOGY CENTER
City SAINT LOUIS
State MO
Zip Code 63110-1026

Providers in the same location

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
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Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 207RC0001X
Grouping Allopathic & Osteopathic Physicians
Classification Internal Medicine
Specialization Clinical Cardiac Electrophysiology

Taxonomy Definition

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.

Providers in the same taxonomy and city

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

Providers in the same taxonomy and state

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
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Competitor

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City SAINT LOUIS
Zip Code 63110

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Dataset Information

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.

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