BALLWIN FAMILY MEDICINE LLC (NPI# 1790204311) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790204311 |
| Entity Type | Organization |
| Organization Name | BALLWIN FAMILY MEDICINE LLC |
| Practice Address |
653 Big Bend Rd Manchester MO 63021-7723 |
| Practice Telephone | (314) 576-2475 |
| Mailing Telephone | 3145762475 |
| Enumeration Date | 2017-09-14 |
| Last Update Date | 2017-09-14 |
| Authorized Official Name | RICK SONNE (DIRECTOR) |
| Authorized Official Telephone | 3145762490 |
| Is Organization Subpart | Y |
| Parent Organization Name | ST. LUKES MEDICAL GROUP |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| Street Address |
653 BIG BEND RD |
| City | MANCHESTER |
| State | MO |
| Zip Code | 63021-7723 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972121176 | Elise Marie Webster | Dietitian, Registered | 822 Posthorn Dr., Manchester, MO 63021 | 2020-07-14 |
| 1386164713 | Our Care LLC | Internal Medicine | 1742 Carman Ridge Ct, Ballwin, MO 63021 | 2017-06-27 |
| 1134675788 | Summit Home Healthcarre, LLC | Home Health | 11511 Manchester Road, Ellisville, MO 63021 | 2016-09-01 |
| 1730530114 | Windalee Cowell-mccavron | Speech-Language Pathologist | 332 Old State Rd, Ellisville, MO 63021 | 2016-06-27 |
| 1013386598 | 16111 Manchester Road, L.L.C. | Dentist | 428 Old State Rd., Ellisville, MO 63021 | 2015-09-15 |
| 1609285816 | Daniel Rackovan | Specialist/Technologist | 13537 Barret Pkwy Dr, 105, Ballwin, MO 63021 | 2014-08-13 |
| 1952651341 | Faisal Alasmari | General Acute Care Hospital | 13928 Reflection Drive, Reflection Cove Apartments, Apt#235, Ballwin, MO 63021 | 2012-09-13 |
| 1831444694 | Manuel A. Ventus | General Practice | 651 Kerryton Pl. Circle, Balwin, MD 63021 | 2012-07-18 |
| 1073879052 | Delois Ann Hurst | Podiatrist | 1393 Big Bend Rd, Ballwin, MO 63021 | 2012-04-04 |
| 1841566445 | Elizabeth Riedel | Home Health | 13610 Barrett Office Drive, Manchester, MO 63021 | 2012-03-28 |
| Find all providers in zip 63021 | ||||
| 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. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861002701 | Kathleen P Fantozzi | Family Medicine | 1590 Union St, Manchester, NH 03104-1768 | 2020-08-05 |
| 1669098570 | Manchester Family Healthcare | Family Medicine | 804 Keylon St Ste B, Manchester, TN 37355-2414 | 2020-06-17 |
| 1043790413 | Sabrina Bolianites | Family Medicine | 765 S Main St Ste 103, Manchester, NH 03102 | 2018-08-15 |
| 1063912459 | Manchester Alcoholism Rehabilitation Center | Family Medicine | 700 Lake Ave Ste 2, Manchester, NH 03103-2734 | 2018-02-13 |
| 1659801892 | Pinnacle Health Regional Physicians | Family Medicine | 4314 N George St Ext'd, Manchester, PA 17345-1307 | 2017-06-19 |
| 1083092282 | Alexander Michael Jones | Family Medicine | 4 Elliot Way Ste 105, Manchester, NH 03103 | 2015-05-08 |
| 1164835138 | Amanda Sue Olberding | Family Medicine | 709 West Main St, Manchester, IA 52057 | 2014-06-08 |
| 1497171318 | Peter J Volk | Family Medicine | 23 Bowdoin Street, Manchester, ME 04351 | 2014-03-17 |
| 1689019242 | R. L. Williams Family Medicine, Pllc | Family Medicine | 1000 Mcarthur St, Manchester, TN 37355-2420 | 2013-05-08 |
| 1689919078 | Mountain Family Practice Clinic of Manchester Inc | Family Medicine | 86 Highway 638, Ste 1, Manchester, KY 40962-7289 | 2012-12-11 |
| Find all providers in MANCHESTER | ||||
| City | MANCHESTER |
| Zip Code | 63021 |
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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.