SSM CARDINAL GLENNON CHILDREN'S HOSPITAL (NPI# 1811074651) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811074651 |
| Entity Type | Organization |
| Organization Name | SSM CARDINAL GLENNON CHILDREN'S HOSPITAL |
| Other Organization Name | CARDINAL GLENNON PEDIATRIC SURGERY CENTER |
| Practice Address |
12700 Southfork Rd Saint Louis MO 63128-3201 |
| Mailing Address |
1465 S Grand Blvd Saint Louis MO 63104-1003 |
| Practice Telephone | 3145435226 |
| Mailing Telephone | 3145775600 |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2011-11-15 |
| Authorized Official Name | MS. LYNN L BOGGS (EVP/COO) |
| Authorized Official Telephone | 3147688032 |
| Is Organization Subpart | Y |
| Parent Organization Name | SSM HEALTH CARE ST. LOUIS |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
167-1 | MO | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 507450302 | 05 |
| Other Name | Type Code |
|---|---|
| Cardinal Glennon Pediatric Surgery Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356412308 | Ssm Cardinal Glennon Children's Hospital | Clinic/Center | 132 Professional Pkwy, Troy, MO 63379-2823 | 2006-11-13 |
| 1962573212 | Ssm Cardinal Glennon Children's Hospital | Clinic/Center | 511 Ashland Ave, Warrenton, MO 63383-1065 | 2006-11-10 |
| 1699087601 | Ssm Cardinal Glennon Children's Hospital | General Acute Care Hospital | 1465 S Grand Blvd, Diet Office, Saint Louis, MO 63104-1003 | 2010-07-07 |
| 1669644456 | Ssm Cardinal Glennon Children's Hospital | Clinic/Center | 1475 Kisker Rd, Suite 120, Saint Charles, MO 63304-8781 | 2008-04-01 |
| 1508935891 | Ssm Cardinal Glennon Children's Hospital | General Acute Care Hospital | 1465 S Grand Blvd, Saint Louis, MO 63104-1003 | 2006-11-08 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | SSM CARDINAL GLENNON CHILDREN'S HOSPITAL | 1465 S Grand Blvd, Saint Louis, MO 63104-1003 |
| Street Address |
12700 SOUTHFORK RD |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63128-3201 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043214778 | Nancy P Bierman Birner | Internal Medicine | 12700 Southfork Rd, Ste 215, Saint Louis, MO 63128-3201 | 2005-06-10 |
| 1588026421 | St. Anthony's Physician Organization | Internal Medicine | 12700 Southfork Rd, Ste 200/220, Saint Louis, MO 63128-3201 | 2016-03-21 |
| 1437515202 | Rebecca Heimburger | Nurse Practitioner | 12700 Southfork Rd, Ste 230, Saint Louis, MO 63128-3201 | 2016-01-11 |
| 1841660792 | Kelly Ann Wilkens | Nurse Practitioner | 12700 Southfork Rd, Ste 200, Saint Louis, MO 63128-3201 | 2015-10-05 |
| 1346631819 | St. Anthony's Physician Organization | Obstetrics & Gynecology | 12700 Southfork Rd, Ste 230, Saint Louis, MO 63128-3201 | 2015-02-05 |
| 1245641968 | St. Anthony's Physician Organization | Internal Medicine | 12700 Southfork Rd, Ste 270, Saint Louis, MO 63128-3201 | 2014-05-15 |
| 1801218300 | St. Anthony's Physician Organization | Surgery | 12700 Southfork Rd, Suite 255, Saint Louis, MO 63128-3201 | 2014-01-17 |
| 1982952560 | Swati Patolia | Internal Medicine | 12700 Southfork Rd, Ste 200 & 220, Saint Louis, MO 63128-3201 | 2012-08-29 |
| 1780945022 | St Anthony's Physician Organization Private Practices, Lc | Audiologist | 12700 Southfork Rd, Suite 255, Saint Louis, MO 63128-3201 | 2012-06-04 |
| 1932491263 | St Anthony's Physician Organization Specialty Services LLC | Assisted Living Facility | 12700 Southfork Rd, Suite 105, Saint Louis, MO 63128-3201 | 2011-05-04 |
| Find all providers in the same location | ||||
| 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 | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467925180 | Metro St Louis Surgery Center LLC | Clinic/Center | 1035 Bellevue Ave Ste 117, Saint Louis, MO 63117-1854 | 2019-01-04 |
| 1295207587 | Commons South Surgery Center, LLC | Clinic/Center | 12345 W Bend Dr Ste 201, Saint Louis, MO 63128-2254 | 2018-12-26 |
| 1922574391 | The Phoenix Oversight and Consulting, LLC. | Clinic/Center | 7746 Rannells Ave, Saint Louis, MO 63143-1823 | 2018-10-23 |
| 1700363611 | Apollo Ambulatory Surgery Center, LLC | Clinic/Center | 10012 Manchester Rd, Saint Louis, MO 63122-1826 | 2018-07-24 |
| 1730698374 | Advanced Surgical Center of Sunset Hills LLC | Clinic/Center | 4594 S Lindbergh Blvd, Saint Louis, MO 63127 | 2017-09-27 |
| 1093230450 | Center for Urologic Surgery LLC | Clinic/Center | 12855 N 40 Dr Ste 100, Saint Louis, MO 63141 | 2017-08-07 |
| 1114317757 | Midamerica Spine Center, LLC | Clinic/Center | 13627 Big Bend Rd, Saint Louis, MO 63122-3915 | 2015-02-04 |
| 1528210770 | South County Outpatient Endoscopy Services, Lp | Clinic/Center | 5139 Mattis Rd, Suite 100, Saint Louis, MO 63128 | 2008-10-21 |
| 1376692681 | Healthmark Brentwood LLC | Clinic/Center | 450 N Lindbergh Blvd Ste A, Saint Louis, MO 63141-7848 | 2007-01-09 |
| 1619026952 | Healthmark Ballas LLC | Clinic/Center | 456 N New Ballas Rd Ste 266, Saint Louis, MO 63141-6842 | 2007-01-09 |
| Find all providers in SAINT LOUIS | ||||
| City | SAINT LOUIS |
| Zip Code | 63128 |
Please comment or provide details below to improve the information on SSM CARDINAL GLENNON CHILDREN'S HOSPITAL.
| 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.