SOUTH COUNTY PAIN INSTITUTE LLC (NPI# 1760778484) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760778484 |
| Entity Type | Organization |
| Organization Name | SOUTH COUNTY PAIN INSTITUTE LLC |
| Practice Address |
4116 Von Talge Rd Saint Louis MO 63128-1957 |
| Practice Telephone | 3143240583 |
| Enumeration Date | 2011-06-21 |
| Last Update Date | 2013-09-30 |
| Authorized Official Name | THOMAS KRAMER (PRESIDENT) |
| Authorized Official Telephone | 3143240583 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 111N00000X | Chiropractor | Chiropractic Providers | ||
| Y | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922395599 | South County Pain Institute LLC | Chiropractor | 4116 Von Talge Rd, Suite B, Saint Louis, MO 63128-1957 | 2011-07-05 |
| Street Address |
4116 VON TALGE RD |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63128-1957 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528088523 | Mark Dayton Belcher | Anesthesiology | 4116 Von Talge Rd, Suite B, Saint Louis, MO 63128-1957 | 2006-07-20 |
| 1295134633 | St Louis Regenerative Medicine and Pain Institute,llc | Chiropractor | 4116 Von Talge Rd, Suite B, Saint Louis, MO 63128-1957 | 2014-08-21 |
| 1922395599 | South County Pain Institute LLC | Chiropractor | 4116 Von Talge Rd, Suite B, Saint Louis, MO 63128-1957 | 2011-07-05 |
| 1811290943 | Ellen Rose Pace | Nurse Practitioner | 4116 Von Talge Rd, Saint Louis, MO 63128-1957 | 2010-12-12 |
| 1023297637 | Ssm Medical Group | Pediatrics | 4116 Von Talge Rd, Saint Louis, MO 63128-1957 | 2007-10-31 |
| 1245422120 | Thomas Mark Kramer | Chiropractor | 4116 Von Talge Rd, Saint Louis, MO 63128-1957 | 2007-08-14 |
| 1275656480 | Stephen G. Nikodem Dds Ms PC | Dentist | 4116 Von Talge Rd, Ste A, Saint Louis, MO 63128-1957 | 2007-04-10 |
| 1285655662 | Christopher Wilson | Pediatrics | 4116 Von Talge Rd, Suite B, Saint Louis, MO 63128-1957 | 2006-07-21 |
| 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 | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| 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 |
|---|---|---|---|---|
| 1780223933 | Glenn C. Jacobsen | Internal Medicine | 7 Carrswold Dr, Saint Louis, MO 63105-2914 | 2020-01-04 |
| 1396305868 | Kevin Colin O'fee | Internal Medicine | 1 Barnes Jewish Hospital Plz # 90-29928, Saint Louis, MO 63110-1003 | 2019-06-17 |
| 1144740200 | Michael Slade | Internal Medicine | 660 S Euclid Ave # 8056-29, Saint Louis, MO 63110-1010 | 2017-06-20 |
| 1386171312 | Niaz Memon | Internal Medicine | 625 S New Ballas Rd Ste 7020, Saint Louis, MO 63141-8218 | 2017-05-22 |
| 1043746027 | Paul David Olivo | Internal Medicine | 639 W Polo Dr, Saint Louis, MO 63105-2635 | 2017-05-11 |
| 1649706243 | Jared Frisby | Internal Medicine | 1100 S Grand Blvd Fl 8, Saint Louis, MO 63104-1015 | 2017-05-03 |
| 1518417708 | Md At Home LLC | Internal Medicine | 6 Portland Pl, Saint Louis, MO 63108-1204 | 2016-10-11 |
| 1285087429 | Kathryn Parker | Internal Medicine | 1000 Des Peres Rd Ste 300, Saint Louis, MO 63131 | 2016-07-22 |
| 1831540863 | John Kirby Krause Jr. | Internal Medicine | 1031 Highlands Plaza Dr W, Apt 510, Saint Louis, MO 63110-1303 | 2016-06-30 |
| 1104277458 | Vedica Sharma | Internal Medicine | 10010 Kennerly Rd Ste 140, Saint Louis, MO 63128-2106 | 2016-06-28 |
| Find all providers in SAINT LOUIS | ||||
| City | SAINT LOUIS |
| Zip Code | 63128 |
Please comment or provide details below to improve the information on SOUTH COUNTY PAIN INSTITUTE 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.