MR. SAMRAT JUN JAYANTH (NPI# 1750945556) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750945556 |
| Entity Type | Individual |
| Full Name | MR. SAMRAT JUN JAYANTH |
| Credential | M.D. |
| Practice Address |
6420 Clayton Road, Ssm Health St Mary's Hospital St. Louis MO 63117 |
| Practice Telephone | 3147688778 |
| Practice Fax Number | 3147687101 |
| Mailing Telephone | 3147688778 |
| Mailing Fax Number | 3147687101 |
| Enumeration Date | 2019-04-26 |
| Last Update Date | 2020-01-11 |
| NPI Deactivation Date | 12/23/2019 |
| NPI Reactivation Date | 2020-01-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
6420 CLAYTON ROAD, SSM HEALTH ST MARY'S HOSPITAL |
| City | ST. LOUIS |
| State | MO |
| Zip Code | 63117 |
| 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 |
| 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 |
| 1659868354 | Francis Rafael Contreras | Student in an Organized Health Care Education/Training Program | 6420 Clayton Road Department of Internal Medicine, Ssm St. Mary's Hospital, St. Louis, MO 63117 | 2018-04-18 |
| Find all providers in zip 63117 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| 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 |
| 1174187264 | Ahsan Ali | Student in an Organized Health Care Education/Training Program | 1438 South Grand Blvd, Monteleone Hall, St. Louis, MO 63104 | 2019-04-24 |
| 1760978688 | Ihab Hassanieh | Student in an Organized Health Care Education/Training Program | 33660 Vista Ave, St. Louis, MO 63110 | 2018-07-03 |
| 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 |
| 1659868354 | Francis Rafael Contreras | Student in an Organized Health Care Education/Training Program | 6420 Clayton Road Department of Internal Medicine, Ssm St. Mary's Hospital, St. Louis, MO 63117 | 2018-04-18 |
| 1437656105 | Manjusha Thenozhiyil | Student in an Organized Health Care Education/Training Program | 6420 Clayton Road., St. Louis, MO 63117 | 2018-04-10 |
| 1497252084 | Badreddien Elsebai Farrag Hammad | Student in an Organized Health Care Education/Training Program | Ssm Health St. Mary's Hospital - St Louis., 6420 Clayton Road., St. Louis, MO 63117 | 2018-04-10 |
| Find all providers in ST. LOUIS | ||||
Please comment or provide details below to improve the information on MR. SAMRAT JUN JAYANTH.
| 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.