| Homer G. Phillips Health Center | |
|
2425 Whittier St Saint Louis MO 63113-2950 | |
| (314) 371-3100 | |
| (314) 289-8718 |
| Full Name | Homer G. Phillips Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 2425 Whittier St, Saint Louis, Missouri |
| Authorized Official Name and Position | Angela R Clabon (CEO) |
| Authorized Official Contact | 3143675820 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Homer G. Phillips Health Center 2425 Whittier St Saint Louis MO 63113-2950 Ph: (314) 367-5820 | Homer G. Phillips Health Center 2425 Whittier St Saint Louis MO 63113-2950 Ph: (314) 371-3100 |
| NPI Number | 1376685529 |
|---|---|
| Provider Enumeration Date | 02/13/2007 |
| Last Update Date | 09/26/2018 |
| Medicare PECOS PAC ID | 1557269289 |
|---|---|
| Medicare Enrollment ID | O20031219000441 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376685529 | NPI | - | NPPES |
| 507523702 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (Missouri) | Primary |
| Provider Name | Michael L Spearman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1164598579 PECOS PAC ID: 8325036890 Enrollment ID: I20040504000272 |
| Provider Name | Katherine M Dewey |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1194786434 PECOS PAC ID: 3375584618 Enrollment ID: I20050518000029 |
| Provider Name | Michael W Rich |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1912925488 PECOS PAC ID: 0244267045 Enrollment ID: I20050725000008 |
| Provider Name | Michael A Specter |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1629021175 PECOS PAC ID: 6709893092 Enrollment ID: I20060310000506 |
| Provider Name | Laila G Hanna |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1336157692 PECOS PAC ID: 8820093131 Enrollment ID: I20060920000182 |
| Provider Name | Srilakshmi Vuyyuru |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1336326438 PECOS PAC ID: 6507920147 Enrollment ID: I20090127000467 |
| Provider Name | Junaid M Syed |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1942381579 PECOS PAC ID: 1951496330 Enrollment ID: I20090818000534 |
| Provider Name | Salwat Shami |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053579094 PECOS PAC ID: 7719027465 Enrollment ID: I20091210000697 |
| Provider Name | Michael G Koenig |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1720171093 PECOS PAC ID: 2466432307 Enrollment ID: I20100806000888 |
| Provider Name | Terri C Coble |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497832224 PECOS PAC ID: 9133017411 Enrollment ID: I20100817001194 |
| Provider Name | Jodie Rai |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1952393191 PECOS PAC ID: 7113041955 Enrollment ID: I20100831000073 |
| Provider Name | Oscar Etuk |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1578518841 PECOS PAC ID: 7719945849 Enrollment ID: I20110913000672 |
| Provider Name | Modupe A Aderibigbe |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1407092927 PECOS PAC ID: 6709937378 Enrollment ID: I20110926000851 |
| Provider Name | Leslie E Mccrary-etuk |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174670418 PECOS PAC ID: 9931203957 Enrollment ID: I20110930000583 |
| Provider Name | Hari K Nallapaneni |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1609076728 PECOS PAC ID: 5991945123 Enrollment ID: I20140815002106 |
| Provider Name | Elena G Ignatova |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1093099830 PECOS PAC ID: 5395047435 Enrollment ID: I20160107000394 |
| Provider Name | Carol D Horton Henley |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1477554848 PECOS PAC ID: 6709189095 Enrollment ID: I20160120001434 |
| Provider Name | Morton S Friedman |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1639343551 PECOS PAC ID: 1951606433 Enrollment ID: I20160222000506 |
| Provider Name | Kia D Washington |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922468305 PECOS PAC ID: 7315245719 Enrollment ID: I20160419001239 |
| Provider Name | Veronica Gregory |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1245647254 PECOS PAC ID: 8224322383 Enrollment ID: I20160811002542 |
| Provider Name | Scott Mccloud |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235674573 PECOS PAC ID: 8729369467 Enrollment ID: I20170111002100 |
| Provider Name | Candias Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063915015 PECOS PAC ID: 4688927940 Enrollment ID: I20181102001694 |
| Provider Name | Julia Anne Pulliam |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1245516350 PECOS PAC ID: 4880840693 Enrollment ID: I20190625001710 |
| Provider Name | La Tanya Lawrence |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104121102 PECOS PAC ID: 2163743071 Enrollment ID: I20190816002633 |
| Provider Name | Andrew J Bova |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1356839971 PECOS PAC ID: 4789004367 Enrollment ID: I20201020003824 |
| Provider Name | Courtney Watza |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1891228557 PECOS PAC ID: 2466720354 Enrollment ID: I20220321000130 |
| Provider Name | Munachi Beatrice Nwosu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871124263 PECOS PAC ID: 7214324235 Enrollment ID: I20220421001549 |
| Provider Name | Meghan Angeline Brauch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730831280 PECOS PAC ID: 4183011901 Enrollment ID: I20220426002500 |
| Provider Name | Amber Linn Aldridge |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689389421 PECOS PAC ID: 7517338577 Enrollment ID: I20230130002437 |
| Provider Name | Jasmine Chadha |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1598115784 PECOS PAC ID: 7911272000 Enrollment ID: I20230227000228 |
| Provider Name | Macy Layton Randolph |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1871215822 PECOS PAC ID: 7113390444 Enrollment ID: I20230307000942 |
| Provider Name | Brooklynn Marlaryce Devitt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407554694 PECOS PAC ID: 6608241419 Enrollment ID: I20230410001628 |
| Provider Name | Jessica Dawn Weseman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871270009 PECOS PAC ID: 6709249956 Enrollment ID: I20230906000377 |
| Provider Name | Dolph D Haege |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1639167570 PECOS PAC ID: 1355380452 Enrollment ID: I20231206003585 |
| Provider Name | Sonia Marie Chase |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1295205516 PECOS PAC ID: 7719342203 Enrollment ID: I20240116002924 |
| Provider Name | Elisha Chantilly Linnen-glass |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1023666278 PECOS PAC ID: 4880047091 Enrollment ID: I20240124001446 |
| Provider Name | Diana Lynn Burton-mitchell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306607247 PECOS PAC ID: 9032554282 Enrollment ID: I20240229004069 |
| Provider Name | Derrick Bark |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1194277582 PECOS PAC ID: 8325484702 Enrollment ID: I20240307001906 |
| Provider Name | Sarah Sapperstein |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558025064 PECOS PAC ID: 9032551171 Enrollment ID: I20240521003507 |
| Provider Name | Lorri Price |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598190373 PECOS PAC ID: 9234362658 Enrollment ID: I20240530002017 |
St. Louis Center For Preventive And Longevity Medicine, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 777 S New Ballas Rd, Suite 200 E, Saint Louis, MO 63141 Phone: 314-994-1536 Fax: 314-692-0241 | |
Town And Country Primary Care Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3009 N Ballas Rd, Suite 300a, Saint Louis, MO 63131 Phone: 314-872-8999 | |
Family Care Health Centers Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1001 Lynch St, Saint Louis, MO 63118 Phone: 314-531-5444 Fax: 314-531-0063 | |
Wusm Bjc Aco Providers Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 660 S Euclid Ave, Campus Box 8081, Saint Louis, MO 63110 Phone: 314-273-0770 | |
Victus Physician Services, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 12607 Olive Blvd, Saint Louis, MO 63141 Phone: 314-327-8070 | |
Salvation Army Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2900 Washington Ave, Saint Louis, MO 63103 Phone: 314-898-1700 Fax: 314-814-8542 | |
Dtg Ii Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3819 Tesson Ct, Saint Louis, MO 63123 Phone: 800-268-7713 Fax: 415-704-3294 |