BOBBI OMORI LAKIN (NPI# 1770961492) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770961492 |
| Entity Type | Individual |
| Full Name | BOBBI OMORI LAKIN |
| Credential | M.D. |
| Practice Address |
4352 Manchester Ave Saint Louis MO 63110 |
| Mailing Address |
4352 Manchester Ave Saint Louis MO 63110-2138 |
| Practice Telephone | 3145315444 |
| Practice Fax Number | 3143531310 |
| Mailing Telephone | 3145315444 |
| Enumeration Date | 2015-05-14 |
| Last Update Date | 2019-10-04 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 2019038679 | MO | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | 10705188-1205 | UT | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | 54987 | TN | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1020 N Highland Ave, Suite C, Murfreesboro, TN 371302494 | 9014485364 | |
| 1365 W 1000 N, Salt Lake City, UT 84116 | 8013285750 | |
| 3031 Medical Center Pkwy Ste B, Murfreesboro, TN 371294243 | 6158468585 | |
| 4352 Manchester Ave, Saint Louis, MO 631102138 | 3145315444 | 3143531310 |
| Street Address |
4352 MANCHESTER AVE |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63110 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245214394 | Harry Richard Scharf | Dentist | 4352 Manchester Ave, Saint Louis, MO 63110-2138 | 2005-12-02 |
| 1881291847 | Chelsea Marie Pierce | Nurse Practitioner | 4352 Manchester Ave, Saint Louis, MO 63110-2138 | 2020-10-02 |
| 1376058586 | Jordanna Riebel | Psychologist | 4352 Manchester Ave, Saint Louis, MO 63110-2138 | 2017-12-11 |
| 1184143596 | Vicki Swyers | Social Worker | 4352 Manchester Ave, Saint Louis, MO 63110-2138 | 2017-09-18 |
| 1407384902 | Alexia Marie Munter | Nurse Practitioner | 4352 Manchester Ave, Saint Louis, MO 63110-2138 | 2017-05-27 |
| 1760772966 | Kenneth Edmond Hemba | Family Medicine | 4352 Manchester Ave, Saint Louis, MO 63110-2138 | 2011-04-10 |
| 1053617407 | Coleen R. Jones | Nurse Practitioner | 4352 Manchester Ave, Saint Louis, MO 63110-2138 | 2011-02-02 |
| 1225358369 | Richard Gerald Bolanos Jr. | Obstetrics & Gynecology | 4352 Manchester Ave, Saint Louis, MO 63110-2138 | 2010-06-10 |
| 1588891576 | Treena Sturgeon | Internal Medicine | 4352 Manchester Ave, Saint Louis, MO 63110-2138 | 2009-06-17 |
| 1881850576 | Kathryn A Simon | Dentist | 4352 Manchester Ave, Saint Louis, MO 63110-2138 | 2008-08-01 |
| 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 | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
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| 1356986541 | Pain Relief Center of St Louis LLC | Family Medicine | 1115 Olivette Executive Pkwy, Saint Louis, MO 63132-3259 | 2019-11-12 |
| 1720635329 | Mercy Clinic East Communities | Family Medicine | 10004 Kennerly Rd Ste 395b, Saint Louis, MO 63128-2190 | 2019-08-20 |
| 1063066777 | Isabella Citizens for Health, Inc. | Family Medicine | 312 Union St, Saint Louis, MI 48880-1830 | 2019-07-31 |
| 1043864010 | Isabella Citizens for Health, Inc. | Family Medicine | 113 E Saginaw St, Saint Louis, MI 48880-1755 | 2019-07-29 |
| 1558896969 | Shivani Sockanathan | Family Medicine | 969 N Mason Rd Ste 145a, Saint Louis, MO 63141-6282 | 2017-04-23 |
| 1598299646 | Kharole Compere | Family Medicine | 175 N Oaks Plz, Saint Louis, MO 63121-2925 | 2017-04-16 |
| 1396109880 | Ritesh Gandhi | Family Medicine | 7345 Watson Rd Ste 203, Saint Louis, MO 63119 | 2016-04-11 |
| 1144608035 | Daniel Urcuyo | Family Medicine | 4625 Lindell Blvd Ste 338, Saint Louis, MO 63108 | 2015-05-11 |
| 1376958728 | Jamil Neme | Family Medicine | 3660 Vista Ave Ste 103, Saint Louis, MO 63110-2540 | 2014-06-24 |
| 1144633819 | Perini Shah | Family Medicine | 12700 Southfork Rd Ste 215, Saint Louis, MO 63128-3276 | 2014-06-10 |
| Find all providers in SAINT LOUIS | ||||
| 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.