DR. ROSEMARY LOUISE CANNISTRARO (NPI# 1790739241) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790739241 |
| Entity Type | Individual |
| Full Name | DR. ROSEMARY LOUISE CANNISTRARO |
| Credential | M.D. PHD |
| Practice Address |
11550 Olive Blvd Ste 140 Creve Coeur MO 63141-7111 |
| Practice Telephone | 3142058344 |
| Practice Fax Number | 3145905931 |
| Mailing Telephone | 3142058344 |
| Mailing Fax Number | 3145905931 |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2011-10-27 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 100907 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | RR MEDICARE | P00257143 | 01 |
| Street Address |
11550 OLIVE BLVD STE 140 |
| City | CREVE COEUR |
| State | MO |
| Zip Code | 63141-7111 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407406986 | Colleen Michelle Dostal | Nurse Practitioner | 11550 Olive Blvd, Creve Coeur, MO 63141-7111 | 2019-09-16 |
| 1154874691 | Carole Ettinger | Nurse Practitioner | 11550 Olive Blvd, Creve Coeur, MO 63141-7111 | 2016-08-02 |
| 1962868901 | Creve Coeur Internal Medicine, LLC | Internal Medicine | 11550 Olive Blvd, Ste 140, Creve Coeur, MO 63141-7111 | 2016-01-06 |
| 1619167483 | Rupinderjit Singh Dhillon | Internal Medicine | 11550 Olive Blvd, Ste 140, Creve Coeur, MO 63141-7111 | 2007-07-27 |
| 1508802976 | Divya Chauhan | Family Medicine | 11550 Olive Blvd, Ste 120, Creve Coeur, MO 63141-7111 | 2006-06-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679102842 | Noor Ramadan | Pharmacist | 628 North New Ballad Road, Suite A, Creve Coeur, MO 63141 | 2020-04-08 |
| 1497381206 | Washington University | Durable Medical Equipment & Medical Supplies | 1044 North Mason Road, Suite 110/210, St. Louis, MO 63141 | 2020-03-13 |
| 1154956498 | Ashleigh Clendenny | Physician Assistant | Mercy Hospital St. Louis, 615 S New Ballas Rd, St. Louis, MO 63141 | 2020-03-06 |
| 1801429410 | Emili Lou Haley | Registered Nurse | 650 Maryville Drive, St Louis, MO 63141 | 2020-02-21 |
| 1629553110 | Rebecca Kathleen Pike | Social Worker | West County Psychological Associates, 12125 Woodcrest Executive Drive #110, St. Louis, MO 63141 | 2018-10-01 |
| 1649756099 | River City Sedation Associates, LLC | Nurse Anesthetist, Certified Registered | 12855 N 40 Dr Ste 150, Saint Louis, MO 63141 | 2018-07-18 |
| 1205333952 | Ear Care and Hearing of St. Louis | Hearing Aid Equipment | 11630 Studt Ave Ste 210, Creve Coeur, MO 63141 | 2018-04-10 |
| 1659897486 | Erin Goodman | Physical Therapist | 10560 Old Olive St. Rd, Suite 100, Creve Coeur, MO 63141 | 2017-08-14 |
| 1093230450 | Center for Urologic Surgery LLC | Clinic/Center | 12855 N 40 Dr Ste 100, Saint Louis, MO 63141 | 2017-08-07 |
| 1871016105 | Jacob Farley Tanner | Specialist/Technologist | 1054 Town and Four Parkway Dr, Creve Coeur, MO 63141 | 2017-07-19 |
| Find all providers in zip 63141 | ||||
| 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 |
|---|---|---|---|---|
| 1558998781 | Mabel Louise Purkerson | Internal Medicine | 20 Haven View Drive, Creve Coeur, MO 63141-7902 | 2020-03-26 |
| 1023467008 | Mid-town Medical Practice, LLC | Internal Medicine | 9 Sackston Woods Ln, Creve Coeur, MO 63141-8228 | 2016-06-09 |
| 1609299023 | Sukanti Raikar | Internal Medicine | 920 Bellerive Manor Dr, Creve Coeur, MO 63141-6094 | 2014-01-22 |
| 1467784843 | Edelmed LLC | Internal Medicine | 12371 Mulberry Tree Ct, Creve Coeur, MO 63141-5470 | 2010-02-09 |
| 1861721748 | Private Md, LLC | Internal Medicine | 11455 Olive Blvd, Creve Coeur, MO 63141-7108 | 2009-12-23 |
| 1033348057 | Delene Prenita Musielak | Internal Medicine | 11550 Olive Blvd Ste 120, Creve Coeur, MO 63141 | 2009-07-12 |
| 1740331735 | Valerie T. Taca | Internal Medicine | 228 Carlyle Lake Dr, Creve Coeur, MO 63141-7544 | 2007-01-16 |
| 1659471795 | Matthew J Orland | Internal Medicine | 969 Mason Road, Ste 145, Creve Coeur, MO 63141 | 2006-09-25 |
| 1861846909 | Johnson Wong | Internal Medicine | 621 S New Ballas Rd Ste 112a, Creve Coeur, MO 63141-8252 | 2016-04-14 |
| 1962868901 | Creve Coeur Internal Medicine, LLC | Internal Medicine | 11550 Olive Blvd, Ste 140, Creve Coeur, MO 63141-7111 | 2016-01-06 |
| Find all providers in CREVE COEUR | ||||
| City | CREVE COEUR |
| Zip Code | 63141 |
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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.