ST LOUIS UNIVERSITY


Address: 1465 S Grand Blvd, Saint Louis, MO 63104-1003
Phone: 3145775600

ST LOUIS UNIVERSITY (NPI# 1962614750) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1962614750
Entity Type Organization
Organization Name ST LOUIS UNIVERSITY
Other Organization Name SLUCARE DEPT OF PEDIATRIC NEURODEVELOPMENTAL DISABILITIES
Practice Address 1465 S Grand Blvd
Saint Louis
MO 63104-1003
Mailing Address 1831 Chestnut St Ste 650
Saint Louis
MO 63103-2236
Practice Telephone 3145775600
Mailing Telephone 3149776828
Enumeration Date 2007-05-04
Last Update Date 2019-06-21
Authorized Official Name ALYCE LANXON (EXECUTIVE DIRECTOR)
Authorized Official Telephone 3149776828
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 2080P0008X Pediatrics
Specialization: Neurodevelopmental Disabilities
Allopathic & Osteopathic Physicians

Other Provider/Organization Names

Other Name Type Code
SLUCARE DEPT OF PEDIATRIC NEURODEVELOPMENTAL DISABILITIES Doing Business As Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1487869863 St Louis University Eyewear Supplier (Equipment, not the service) 1755 South Grand, St Louis, MO 63104 2007-05-11
1194892463 St Louis University Orthopaedic Surgery 1831 Chestnut St Ste 650, Saint Louis, MO 63103 2006-11-29
1093894842 St Louis University Internal Medicine 10 Franklin, Washington, MO 63090 2006-11-03
1417035759 St Louis University Audiologist 3750 Lindell, St Louis, MO 63108 2006-11-02
1992778237 St Louis University Urology 3655 Vista Ave, Saint Louis, MO 63110-2539 2006-02-08
1164495412 St Louis University Pathology 1402 South Grand, St Louis, MO 63104 2006-02-08
1801869136 St Louis University Psychiatry & Neurology 1438 S Grand Blvd, Saint Louis, MO 63104-1027 2006-02-08
1740253095 St Louis University Dermatology 1755 S Grand Blvd, Saint Louis, MO 63104-1540 2006-02-08
1184266413 St Louis University Pediatrics 1465 S Grand Blvd, Saint Louis, MO 63104-1003 2019-10-08
1184908865 St Louis University Urology 1465 S Grand Blvd, Saint Louis, MO 63104-1003 2011-09-29

Office Location

Street Address 1465 S GRAND BLVD
City SAINT LOUIS
State MO
Zip Code 63104-1003

Providers in the same location

NPI Name Taxonomy Address Enumeration
1528676921 Gunjanpreet Kaur Student in an Organized Health Care Education/Training Program 1465 S Grand Blvd, Saint Louis, MO 63104-1003 2020-07-21
1972128510 Millicent Rose Palacios Nurse Practitioner 1465 S Grand Blvd, Saint Louis, MO 63104-1003 2020-06-09
1083241863 Nathaniel Joseph Conner Student in an Organized Health Care Education/Training Program 1465 S Grand Blvd, Saint Louis, MO 63104-1003 2020-03-24
1467089177 Stacy Kollanur Mathews Student in an Organized Health Care Education/Training Program 1465 S Grand Blvd, Saint Louis, MO 63104-1003 2020-03-24
1568099299 Susan Aye Mya Oo Student in an Organized Health Care Education/Training Program 1465 S Grand Blvd, Saint Louis, MO 63104-1003 2020-03-24
1861029514 Gregory Joseph Weissler II Student in an Organized Health Care Education/Training Program 1465 S Grand Blvd, Saint Louis, MO 63104-1003 2020-03-24
1154958874 Brendan Michael Mcenery Student in an Organized Health Care Education/Training Program 1465 S Grand Blvd, Saint Louis, MO 63104-1003 2020-03-24
1316574049 Satvika Mikkilineni Student in an Organized Health Care Education/Training Program 1465 S Grand Blvd, Saint Louis, MO 63104-1003 2020-03-24
1972130607 Katherine Letha Randolph Student in an Organized Health Care Education/Training Program 1465 S Grand Blvd, Saint Louis, MO 63104-1003 2020-03-24
1346877081 Samuel Ryan Richey Student in an Organized Health Care Education/Training Program 1465 S Grand Blvd, Saint Louis, MO 63104-1003 2020-03-24
Find all providers in the same location

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1407469570 Family Care Health Centers Clinic/Center 2717 Sidney Street, St. Louis, MO 63104 2020-08-28
1023638038 Laura Ann Humphrey Physician Assistant Allied Health Building 3437 Caroline Street, Room 3015, Saint Louis, MO 63104 2020-04-20
1174187264 Ahsan Ali Student in an Organized Health Care Education/Training Program 1438 South Grand Blvd, Monteleone Hall, St. Louis, MO 63104 2019-04-24
1205359916 Brenda Eve Ladin Behavior Technician 1221 Allen Market Lane Rear, St. Louis, MO 63104 2017-07-25
1841722063 Gustavo G Mendez Student in an Organized Health Care Education/Training Program 1465 South Grand Bulevard Rm 2717, Ssm Health Cardinal Glennon Children's Hospital, Saint Louis, MO 63104 2017-03-28
1053776716 Carmella Harper Respiratory Therapist, Certified 2678 Park Ave, St Louis, MO 63104 2015-12-23
1922485986 Alexander Tremont Internal Medicine 1402 S Grand Blvd Rm M260, Saint Louis, MO 63104 2015-04-29
1306233341 Healthcare R Us Home Health 2859 Sidney St, St Louis, MO 63104 2015-04-16
1396159091 Daniela Hermelin Pathology 1402 South Grane, St. Louis, MO 63104 2014-06-20
1992117881 Kelly Denise Durbin Social Worker 1920 S 7th St, Saint Louis, MO 63104 2014-05-27
Find all providers in zip 63104

Taxonomy Information

Taxonomy Code 2080P0008X
Grouping Allopathic & Osteopathic Physicians
Classification Pediatrics
Specialization Neurodevelopmental Disabilities

Taxonomy Definition

A pediatrician who treats children having developmental delays or learning disorders including those associated with visual and hearing impairment, mental retardation, cerebral palsy, spina bifida, autism and other chronic neurologic conditions. This specialist provides medical consultation and education and assumes leadership in the interdisciplinary management of children with neurodevelopmental disorders. They may also focus on the early identification and diagnosis of neurodevelopmental disabilities in infants and young children as well as on changes that occur as the child with developmental disabilities grows.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source changed] Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1558362384 Gretchen Anne Meyer Pediatrics 641 N New Ballas Rd, Saint Louis, MO 63141-6713 2005-08-02
1053674630 Mercy Childrens Therapy and Development LLC Pediatrics 641 N New Ballas Rd, Saint Louis, MO 63141-6713 2012-06-19
1912132663 Srikanth Thalakoti Pediatrics 621 S New Ballas Rd, Suite 5009b, Saint Louis, MO 63141-8232 2009-05-26
1528186863 St. Louis Child Neurology Services, P.C. Pediatrics 621 S New Ballas Rd, 5009b, Saint Louis, MO 63141-8232 2007-03-26
1528163904 John F Mantovani Pediatrics 621 S New Ballas Rd, 5009 B, Saint Louis, MO 63141-8232 2006-09-13

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1740584747 Brian Michael Aalbers Pediatrics 2401 Gillham Rd, Kansas City, MO 64108-4619 2011-01-05
1679649529 Regional Services Pediatrics 1000 E Primrose St, Suite 200, Springfield, MO 65807 2006-11-24
1629168380 Lester E. Cox Medical Centers Pediatrics 1000 E Primrose St, Suite 200, Springfield, MO 65807-5154 2006-10-13
1821182197 Eugene M Tenorio Pediatrics 1000 E Primrose St, Suite 200, Springfield, MO 65807-5154 2006-10-03
1497768600 Arie Ashkenasi Pediatrics 1000 E Primrose St, #200, Springfield, MO 65807-5154 2006-08-15
1609828375 Pediatric Therapy Services, Inc. Pediatrics 5431 Main Street, Kansas City, MO 64112-2823 2006-05-17

Competitor

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City SAINT LOUIS
Zip Code 63104

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Dataset Information

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.

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