MERCY CLINIC EAST COMMUNITIES (NPI# 1851335228) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851335228 |
| Entity Type | Organization |
| Organization Name | MERCY CLINIC EAST COMMUNITIES |
| Other Organization Name | MERCY MEDICAL GROUP |
| Practice Address |
615 S New Ballas Rd Administration Building, 5th Floor Saint Louis MO 63141-8221 |
| Practice Telephone | 3142516000 |
| Mailing Telephone | 3142516000 |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2014-05-08 |
| Authorized Official Name | JOHN W. HUBERT (PRESIDENT) |
| Authorized Official Telephone | 3142511700 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | Y |
| Parent Organization Name | MERCY HEALTH EAST COMMUNITIES |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians | ||
| N | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians | ||
| Y | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 500228804 | 05 |
| Other Name | Type Code |
|---|---|
| Mercy Medical Group | Former Legal Business Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720635329 | Mercy Clinic East Communities | Family Medicine | 10004 Kennerly Rd Ste 395b, Saint Louis, MO 63128-2190 | 2019-08-20 |
| 1164857397 | Mercy Clinic East Communities | Clinic/Center | 16555 Manchester Rd Ste 110, Wildwood, MO 63040-1220 | 2013-09-06 |
| 1235493776 | Mercy Clinic East Communities | Clinic/Center | 125 N Old Highway 66, Bourbon, MO 65441-6298 | 2012-06-29 |
| 1700370061 | Mercy Clinic East Communities | Internal Medicine | 15945 Clayton Rd Ste 310, Ballwin, MO 63011-2493 | 2018-06-20 |
| 1285998724 | Mercy Clinic East Communities | Clinic/Center | 301 Theresa St, Cuba, MO 65453-1636 | 2012-06-29 |
| 1467716928 | Mercy Clinic East Communities | Clinic/Center | 101 Progress Pkwy, Sullivan, MO 63080-2359 | 2012-06-29 |
| 1619231164 | Mercy Clinic East Communities | Clinic/Center | 520 Pine St, Steelville, MO 65565-6041 | 2012-06-29 |
| 1043574940 | Mercy Clinic East Communities | Allergy & Immunology | 615 S New Ballas Rd, Administration Building, 5th Floor, Saint Louis, MO 63141-8221 | 2012-06-26 |
| 1073739041 | Mercy Clinic East Communities | Family Medicine | 615 S New Ballas Rd, Administrative Building, 5th Floor, Saint Louis, MO 63141-8221 | 2007-04-18 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | MERCY CLINIC EAST COMMUNITIES | 645 Maryville Centre Dr, Saint Louis, MO 63141-5855 |
| Street Address |
615 S NEW BALLAS RD ADMINISTRATION BUILDING, 5TH FLOOR |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63141-8221 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780689182 | Robert W Allen | Anesthesiology | 615 S New Ballas Rd, Saint Louis, MO 63141-8221 | 2005-06-14 |
| 1033722061 | Ashley Maull | Nurse Practitioner | 615 S New Ballas Rd, Saint Louis, MO 63141-8221 | 2020-08-28 |
| 1508476367 | Ryan Nathan | Student in an Organized Health Care Education/Training Program | 615 S New Ballas Rd, Saint Louis, MO 63141-8221 | 2020-08-06 |
| 1992315857 | Corey Weicht | Nurse Practitioner | 615 S New Ballas Rd, Saint Louis, MO 63141-8221 | 2020-08-05 |
| 1063021905 | Alexandria Colleen Grodie | Nurse Practitioner | 615 S New Ballas Rd, Saint Louis, MO 63141-8221 | 2020-07-27 |
| 1396353892 | Fahad Bin Tahir | Internal Medicine | 615 S New Ballas Rd, Saint Louis, MO 63141-8221 | 2020-07-21 |
| 1588281307 | Alexander Cai | Dentist | 615 S New Ballas Rd, Saint Louis, MO 63141-8221 | 2020-06-26 |
| 1083231070 | Lauren Gonzalez | Anesthesiologist Assistant | 615 S New Ballas Rd, Saint Louis, MO 63141-8221 | 2020-06-25 |
| 1780200253 | Matthew Davis | Internal Medicine | 615 S New Ballas Rd, Saint Louis, MO 63141-8221 | 2020-06-22 |
| 1902422421 | Megan Reidy Landis | Family Medicine | 615 S New Ballas Rd, Saint Louis, MO 63141-8221 | 2020-06-20 |
| Find all providers in the same location | ||||
| 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 |
|---|---|---|---|---|
| 1780223933 | Glenn C. Jacobsen | Internal Medicine | 7 Carrswold Dr, Saint Louis, MO 63105-2914 | 2020-01-04 |
| 1396305868 | Kevin Colin O'fee | Internal Medicine | 1 Barnes Jewish Hospital Plz # 90-29928, Saint Louis, MO 63110-1003 | 2019-06-17 |
| 1144740200 | Michael Slade | Internal Medicine | 660 S Euclid Ave # 8056-29, Saint Louis, MO 63110-1010 | 2017-06-20 |
| 1386171312 | Niaz Memon | Internal Medicine | 625 S New Ballas Rd Ste 7020, Saint Louis, MO 63141-8218 | 2017-05-22 |
| 1043746027 | Paul David Olivo | Internal Medicine | 639 W Polo Dr, Saint Louis, MO 63105-2635 | 2017-05-11 |
| 1649706243 | Jared Frisby | Internal Medicine | 1100 S Grand Blvd Fl 8, Saint Louis, MO 63104-1015 | 2017-05-03 |
| 1518417708 | Md At Home LLC | Internal Medicine | 6 Portland Pl, Saint Louis, MO 63108-1204 | 2016-10-11 |
| 1285087429 | Kathryn Parker | Internal Medicine | 1000 Des Peres Rd Ste 300, Saint Louis, MO 63131 | 2016-07-22 |
| 1831540863 | John Kirby Krause Jr. | Internal Medicine | 1031 Highlands Plaza Dr W, Apt 510, Saint Louis, MO 63110-1303 | 2016-06-30 |
| 1104277458 | Vedica Sharma | Internal Medicine | 10010 Kennerly Rd Ste 140, Saint Louis, MO 63128-2106 | 2016-06-28 |
| Find all providers in SAINT LOUIS | ||||
| City | SAINT LOUIS |
| 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.