THOMAS SHINE (NPI# 1861417255) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861417255 |
| Entity Type | Individual |
| Full Name | THOMAS SHINE |
| Credential | M.D. |
| Practice Address |
1225 Graham Rd Florissant MO 63031-8014 |
| Mailing Address |
75 Remit Dr Lockbox 6804 Chicago IL 60675-6804 |
| Practice Telephone | 3149536000 |
| Mailing Telephone | 8669165259 |
| Mailing Fax Number | 2319224030 |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2009-03-02 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207P00000X | Emergency Medicine | 036-105380 | IL | Allopathic & Osteopathic Physicians |
| Y | 207P00000X | Emergency Medicine | R7482 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 201809118 | 05 |
| Street Address |
1225 GRAHAM RD |
| City | FLORISSANT |
| State | MO |
| Zip Code | 63031-8014 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265431399 | Antonio R Penilla | Internal Medicine | 1225 Graham Rd, Ste 2310c, Florissant, MO 63031-8012 | 2005-07-20 |
| 1912549452 | Erica Frazier | Social Worker | 1225 Graham Rd, Florissant, MO 63031-8012 | 2019-10-16 |
| 1275174088 | Pamela Wooten | Registered Nurse | 1225 Graham Rd, Florissant, MO 63031-8012 | 2019-10-02 |
| 1700357647 | John A Powers | Nurse Practitioner | 1225 Graham Rd, Florissant, MO 63031-8012 | 2018-12-17 |
| 1922454719 | Jenna O'shea | Nurse Practitioner | 1225 Graham Rd, Ste 1340c, Florissant, MO 63031-8012 | 2016-05-11 |
| 1093135980 | Daniel Zwilling | Physician Assistant | 1225 Graham Rd, Florissant, MO 63031-8012 | 2014-04-18 |
| 1356769012 | Lindsay Riedl Jaeger | Pediatrics | 1225 Graham Rd, Florissant, MO 63031-8012 | 2014-03-31 |
| 1942627823 | Kathryn A Spectorsky | Pediatrics | 1225 Graham Rd, Florissant, MO 63031-8012 | 2014-03-27 |
| 1124459730 | Javda Miasha Wilson | Nurse Practitioner | 1225 Graham Rd, Florissant, MO 63031-8012 | 2013-12-06 |
| 1013358100 | Laura M Gramolino | Nurse Practitioner | 1225 Graham Rd, Florissant, MO 63031-8012 | 2013-07-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528550019 | A Precious Home Care Solution Cds LLC | Home Health | 2367 Periwinkle Court, Florisant, MO 63031 | 2018-05-31 |
| 1932625415 | Haven of Grooming | Specialist | 51 Florissant Oaks Shop Center, Florissant, MO 63031 | 2017-08-16 |
| 1841696648 | Deandra's Angels Home Care | Home Health | 1985 Lindsay Lane, Florissant, MO 63031 | 2014-11-06 |
| 1871907378 | Daniel Joseph Watson | Ophthalmology | 900 N Highway 67 St, Florissant, MO 63031 | 2014-06-12 |
| 1124449954 | Edgar Micere | Occupational Therapy Assistant | 1 Paul Place Ct, Florissant, MO 63031 | 2013-12-20 |
| 1699019190 | Dushanas Touch of Love Transportation L.l.c | Non-emergency Medical Transport (VAN) | 3011 Oriental Dr, Florissant, MO 63031 | 2012-11-21 |
| 1790038321 | Pleasant Solutions Home Health Care,llc | Community Based Residential Treatment Facility, Mental Illness | 100 Rue St. Francios Suite 107, Saint Louis, MO 63031 | 2012-10-19 |
| 1114279460 | Access Dental & Dentures LLC | Dentist | 565 Howdershell Rd, Florissant, MO 63031 | 2012-10-11 |
| 1982980843 | Lauren Heimberger | Pharmacist | 15390 New Halls Ferry, Florissant, MO 63031 | 2011-10-24 |
| 1578878732 | North County Adult Center LLC | Registered Nurse | 500 Greenway Manor Dr, Florissant, MO 63031 | 2010-08-12 |
| Find all providers in zip 63031 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215190558 | Cynthia Xakellis Wiederholt | Emergency Medicine | Fast Track Urgent Care, 2686 N Highway 67, Florissant, MO 63023-1438 | 2008-07-07 |
| 1861722803 | Michael M Matar | Emergency Medicine | 2175 Charbonier Rd, Suite B, Florissant, MO 63031-5500 | 2010-01-13 |
| 1578589412 | Cynthia Bleichroth | Emergency Medicine | 1225 Graham Rd, Florissant, MO 63031-8014 | 2006-07-14 |
| 1770508160 | Raj Shivaji | Emergency Medicine | 1225 Graham Rd, Florissant, MO 63031-8014 | 2006-07-13 |
| 1487679882 | Roger Waxelman | Emergency Medicine | 1225 Graham Rd, Florissant, MO 63031-8014 | 2006-07-13 |
| 1295750693 | William Weston | Emergency Medicine | 1225 Graham Rd, Florissant, MO 63031-8014 | 2006-07-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053972349 | Alanna Diamond | Emergency Medicine | One Hospital Drive Emergency Medicine M652 Dc029.10, Columbia, MO 65212-0001 | 2019-06-26 |
| 1013573146 | Michael Habhab | Emergency Medicine | 1 Hospital Dr Emergency Medicine M562 Dc029.10, Columbia, MO 65212-0001 | 2019-05-14 |
| 1043730716 | Ian James Becker | Emergency Medicine | 1 Hospital Dr # Dc029.10, Columbia, MO 65212-1000 | 2017-06-23 |
| 1649628454 | Sphere Medical Group | Emergency Medicine | 916 Olive St Fl 4, Saint Louis, MO 63101-1459 | 2016-06-02 |
| 1487002523 | Christopher Adam Waranch | Emergency Medicine | University of Missouri Columbia, Department of Emergency Medicine, Columbia, MO 65212-0001 | 2016-05-31 |
| 1306220488 | Andrea Marie-gioia Spangler | Emergency Medicine | 1235 E Cherokee St Dept Of, Springfield, MO 65804-2203 | 2015-07-17 |
| 1205219045 | Maria Christina Creel-bulos | Emergency Medicine | 660 South Euclid Avenue Cb 8072, St Louis, MO 63110 | 2015-06-29 |
| 1669853230 | Megan Litzau | Emergency Medicine | 615 S New Ballas Road, St Louis, MO 63141 | 2015-06-09 |
| 1366829426 | Bigeye Emergency Physicians LLC | Emergency Medicine | 10 South Hospital Deive, Fulton, MO 65251 | 2015-04-28 |
| 1972999225 | Timothy O Olatunde | Emergency Medicine | 4410 Wornall Road, Kansas City, MO 64111 | 2015-04-14 |
| Find all providers with the same taxonomy | ||||
| City | FLORISSANT |
| Zip Code | 63031 |
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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.