BOONSLICK PEDIATRICS (NPI# 1962675744) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962675744 |
| Entity Type | Organization |
| Organization Name | BOONSLICK PEDIATRICS |
| Practice Address |
5600 Mexico Rd Ste 21 Saint Peters MO 63376-1660 |
| Practice Telephone | 6364414144 |
| Practice Fax Number | 6364414112 |
| Mailing Telephone | 6364414144 |
| Mailing Fax Number | 6364414112 |
| Enumeration Date | 2008-04-11 |
| Last Update Date | 2008-04-11 |
| Authorized Official Name | DR. ROBERT J LOBONC (MD) |
| Authorized Official Telephone | 6364414144 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 305R00000X | Preferred Provider Organization | R7C25 | MO | Managed Care Organizations |
| Street Address |
5600 MEXICO RD STE 21 |
| City | SAINT PETERS |
| State | MO |
| Zip Code | 63376-1660 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265634513 | Vijaya Nattuvetty Vasudevan | Internal Medicine | 5600 Mexico Rd Ste 21, Saint Peters, MO 63376-1660 | 2007-05-31 |
| 1659869857 | Vvasudevan LLC | Internal Medicine | 5600 Mexico Rd Ste 21, Saint Peters, MO 63376-1660 | 2018-04-24 |
| 1275714784 | Venkata Kr Bodavula | Surgery | 5600 Mexico Rd Ste 21, Saint Peters, MO 63376-1660 | 2007-11-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275047946 | Nicholas Christian Schultz | Dentist | 100 Piper Hill Dr Ste A, Saint Peters, MO 63376 | 2017-11-16 |
| 1982120093 | Carol Weber | Speech-Language Pathologist | 166 Boone Hills Dr., St Peters, MO 63376 | 2017-08-21 |
| 1619424744 | Forefront Dermatology, S.c. | Dermatology | 5700 Mexico Rd, Suite 14, Saint Peters, MO 63376 | 2016-09-07 |
| 1508310632 | Preferred Family Healthcare, Inc. | Counselor | 2120 Parkway Dr, Saint Peters, MO 63376 | 2016-08-05 |
| 1598130676 | Delta Center Personal Attendant Services | In Home Supportive Care | 3833 Mcclay, Suite 61, St. Peters, MO 63376 | 2015-12-01 |
| 1427420314 | Barbara Marlene Edelman | Counselor | 1286 Jungerman Rd. Suite G, St. Peters, MO 63376 | 2015-10-30 |
| 1255740247 | Claire Williams | Dentist | 340 Mid Rivers Mall Drive, Suite E, St. Peters, MO 63376 | 2014-08-05 |
| 1184042855 | Keith Wickenhauser | Internal Medicine | 201 Bjc Saint Peters Dr Ste 100, Saint Peters, MO 63376 | 2014-03-31 |
| 1821415233 | Abby Link | Physician Assistant | 107 Piper Parkway, #150, St. Peters, MO 63376 | 2014-03-24 |
| 1225452105 | Ashley Gagel | Physical Therapist | 7055 Mexico Rd Suite 1601, St. Peters, MO 63376 | 2014-02-12 |
| Find all providers in zip 63376 | ||||
| Taxonomy Code | 305R00000X |
| Grouping | Managed Care Organizations |
| Classification | Preferred Provider Organization |
| A group of physicians and/or hospitals who contract with an employer to provide services to their employees. In a PPO, the patient may got to the physician of his/her choice, even if that physician does not participate in the PPO, but the patient receives care at a lower benefit level. |
| Notes: Source: "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/ October 1995, p. 62 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053945105 | Premier Cds Services | Preferred Provider Organization | 4144 Lindell Blvd Ste 218, Saint Louis, MO 63108-2932 | 2020-02-27 |
| 1689216186 | Isaihs Angels In-home Healthcare, LLC | Preferred Provider Organization | 1276 Saint Cyr Rd Ste 123, Saint Louis, MO 63137-1224 | 2019-10-16 |
| 1811409253 | Outreach Home Healthcare Agency LLC | Preferred Provider Organization | 10351 Capitol Dr, Saint Louis, MO 63136-4305 | 2017-10-25 |
| 1497291090 | Anointing Loving Carellc | Preferred Provider Organization | 769 Laredo Ave, Saint Louis, MO 63138-3633 | 2017-01-06 |
| 1700242872 | Our Hands That Care Ihs LLC | Preferred Provider Organization | 4144 Lindell Blvd Ste 312a, Saint Louis, MO 63108-2953 | 2016-01-05 |
| 1558779934 | Trugia Care | Preferred Provider Organization | 617 Seaton Blvd, Raymore, MO 64083-8311 | 2014-07-29 |
| 1154755338 | Angels Within Cds LLC | Preferred Provider Organization | 4108 W Florissant Ave, Saint Louis, MO 63115-3056 | 2013-08-24 |
| 1285939777 | Emily Katherine Handley. | Preferred Provider Organization | 14227 E Highway 40, Kansas City, MO 64136-1187 | 2011-01-14 |
| 1508185687 | Nancy Williger Phd LLC | Preferred Provider Organization | 745 Old Frontenac Sq Ste 201, Saint Louis, MO 63131-2755 | 2010-05-27 |
| 1578893137 | Towne Dental of Oak Grove LLC | Preferred Provider Organization | 1206 S Broadway, Oak Grove, MO 64075-9100 | 2010-01-05 |
| Find all providers with the same taxonomy | ||||
| City | SAINT PETERS |
| Zip Code | 63376 |
Please comment or provide details below to improve the information on BOONSLICK PEDIATRICS.
| 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.