SUSHRUTH EDLA (NPI# 1821343179) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821343179 |
| Entity Type | Individual |
| Full Name | SUSHRUTH EDLA |
| Credential | M.D. |
| Practice Address |
1390 Us Highway 61 Ste N1500 Festus MO 63028-4137 |
| Practice Telephone | 6369335055 |
| Mailing Telephone | 6369335055 |
| Enumeration Date | 2012-07-23 |
| Last Update Date | 2019-08-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | 57.020812 | OH | Allopathic & Osteopathic Physicians |
| N | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
2019014001 | MO | Allopathic & Osteopathic Physicians |
| Y | 207RI0011X |
Internal Medicine Specialization: Interventional Cardiology |
2019014001 | MO | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | 57.020812 | OH | Student, Health Care |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2351 E 22nd St, #342w, Cleveland, OH 441153111 | 2163632725 |
| Street Address |
1390 US HIGHWAY 61 STE N1500 |
| City | FESTUS |
| State | MO |
| Zip Code | 63028-4137 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811982754 | Pascal E. Gaudreault | Emergency Medicine | 1390 Us Highway 61 Ste N1500, Festus, MO 63028 | 2005-09-16 |
| 1215445622 | Courtney Rose Gray | Nurse Practitioner | 1390 Us Highway 61 Ste N1500, Festus, MO 63028 | 2018-01-19 |
| 1265482509 | Dale E Doerr | Orthopaedic Surgery | 1390 Us Highway 61 Ste N1500, Festus, MO 63028-4137 | 2006-05-10 |
| 1538118575 | Paul Ramon Maynard | Orthopaedic Surgery | 1390 Us Highway 61 Ste N1500, Festus, MO 63028-4137 | 2006-05-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952943268 | Lauryn E Morris | Occupational Therapist | 3657 Baptist Park Rd, Mapaville, MO 63028 | 2019-10-09 |
| 1912557547 | Rena Robinson | Technician | 150 Brandon Wallace Way Suite 1014, Suite 1014, Festus, MO 63028 | 2019-09-16 |
| 1780232264 | Cynthia L James | Technician | 110 Juliet Place, Festus, MO 63028 | 2019-08-28 |
| 1700377009 | Akr Endodontics, LLC | Dentist | 1431 Us Hwy 61, Festus, MO 63028 | 2018-05-22 |
| 1962869990 | Fatma Esen Antakli | Nurse Practitioner | Advanced Pain Centers 190 Industrial Drive, Festus, MO 63028 | 2016-01-21 |
| 1083088744 | Megan Schomer | Counselor | 2675 Meyer Rd, Festus, MO 63028 | 2015-11-18 |
| 1043608144 | Elka Follmer | Physical Therapist | 1349 Us Hwy 61, Festus, MO 63028 | 2014-12-26 |
| 1811394729 | Ashley Schwendeman | Physical Therapist | 1403 N. Truman Blvd, Fesuts, MO 63028 | 2014-11-21 |
| 1073871257 | Staurla Chantel Waun | Counselor | 10719 Buckeye Rd, Festus, MO 63028 | 2012-04-25 |
| 1639444086 | Jeffrey Steitz | Otolaryngology | 1390 Us Highway 61 Ste 3100, Festus, MO 63028 | 2012-03-19 |
| Find all providers in zip 63028 | ||||
| Taxonomy Code | 207RI0011X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Interventional Cardiology |
| An area of medicine within the subspecialty of cardiology, which uses specialized imaging and other diagnostic techniques to evaluate blood flow and pressure in the coronary arteries and chambers of the heart and uses technical procedures and medications to treat abnormalities that impair the function of the cardiovascular system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/ Board Certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. ACGME Accredited Residency Program Requirements: 1 year of training plus a prerequisite of 3 years Internal Medicine, 3 years Cardiovascular Disease for a total of 7 years. ABMS Approved Subspecialty Certificate (Internal Medicine) |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033370358 | Shamail S. Tariq | Internal Medicine | 1071 Airport Rd, Festus, MO 63028-4103 | 2008-06-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275032286 | Cardiac Cin of Kansas City LLC | Internal Medicine | 111 W 10th St Ste 103, Kansas City, MO 64105-1700 | 2018-02-05 |
| 1437658440 | Cardiac Cin of St Louis LLC | Internal Medicine | 11628 Old Ballas Rd # 346, Saint Louis, MO 63141-7030 | 2018-02-05 |
| 1629366984 | Jorge Marcelo Ramirez Romero | Internal Medicine | 1402 S. Grand, Fdt 14th Floor, St. Louis, MO 63104 | 2011-07-20 |
| 1164737490 | Mohan Mallikarjuna Edupuganti | Internal Medicine | 901 Patients First Dr Ste 2500, Washington, MO 63090 | 2010-08-11 |
| 1285945295 | Byungsoo Ko | Internal Medicine | 100 Mercy Way Ste 320, Joplin, MO 64804-4524 | 2010-06-24 |
| 1104083351 | Cardiovascular Institute of Jacksonville P A | Internal Medicine | 1406 Ridgetree Trails Dr, Wildwood, MO 63021-5930 | 2008-05-16 |
| 1053401422 | Gus Theodos | Internal Medicine | 710 S Price Rd, Saint Louis, MO 63124-1867 | 2006-10-13 |
| 1225134117 | William R Reilly Inc | Internal Medicine | 450 N. New Ballas Rd, Ste 170w, St. Louis, MO 63141-6835 | 2006-09-16 |
| 1881799336 | Morton R. Rinder | Internal Medicine | 222 S Woods Mill Rd Ste 560, Chesterfield, MO 63017-3625 | 2006-09-13 |
| 1902834625 | Skaggs Community Hospital Association | Internal Medicine | 1150 State Hwy 248, Branson, MO 65616-2075 | 2006-06-29 |
| Find all providers with the same taxonomy | ||||
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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.