| Innovare Health Advocates | |
|
9915 Kennerly Rd Suite J Saint Louis MO 63128-2703 | |
| (314) 843-4794 | |
| (314) 843-9256 |
| Full Name | Innovare Health Advocates |
|---|---|
| Speciality | Internal Medicine |
| Location | 9915 Kennerly Rd, Saint Louis, Missouri |
| Authorized Official Name and Position | Charles J. Willey (OWNER/PHYSICIAN) |
| Authorized Official Contact | 3148434794 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Innovare Health Advocates 9915 Kennerly Rd Suite J Saint Louis MO 63128-2703 Ph: (314) 843-4794 | Innovare Health Advocates 9915 Kennerly Rd Suite J Saint Louis MO 63128-2703 Ph: (314) 843-4794 |
| NPI Number | 1477876423 |
|---|---|
| Provider Enumeration Date | 03/04/2010 |
| Last Update Date | 03/12/2020 |
| Medicare PECOS PAC ID | 9537293816 |
|---|---|
| Medicare Enrollment ID | O20100823000820 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477876423 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (Missouri) | Primary |
| Provider Name | Ehab Kaiser |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205804796 PECOS PAC ID: 6002863354 Enrollment ID: I20050407001105 |
| Provider Name | Becky J Ganz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922208024 PECOS PAC ID: 8325130891 Enrollment ID: I20070828001128 |
| Provider Name | Marlon Marquino |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366642704 PECOS PAC ID: 8921194192 Enrollment ID: I20071018000701 |
| Provider Name | Barbara Ann Mulholland-younge |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689874463 PECOS PAC ID: 0547358251 Enrollment ID: I20071114000065 |
| Provider Name | Charles Willey |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1811996028 PECOS PAC ID: 0244205615 Enrollment ID: I20071203000615 |
| Provider Name | Erin M Holloway |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033369798 PECOS PAC ID: 6608936497 Enrollment ID: I20081124000734 |
| Provider Name | Paul B Vatterott |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1346239381 PECOS PAC ID: 8628139441 Enrollment ID: I20081211000190 |
| Provider Name | Siroth Charnond |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1265421218 PECOS PAC ID: 3779617352 Enrollment ID: I20100818000515 |
| Provider Name | Laura L Hill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194923151 PECOS PAC ID: 3375668874 Enrollment ID: I20100920001216 |
| Provider Name | Melissa A Grizzle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205124070 PECOS PAC ID: 4284892753 Enrollment ID: I20120301000262 |
| Provider Name | Stephanie L Graham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306238704 PECOS PAC ID: 5395065452 Enrollment ID: I20150513002389 |
| Provider Name | Albert Wayne Scrimsher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972053833 PECOS PAC ID: 7517245962 Enrollment ID: I20161107000044 |
| Provider Name | Emil Trevis Fernando |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1982968129 PECOS PAC ID: 2567787237 Enrollment ID: I20170130000111 |
| Provider Name | Monica Dunn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861948044 PECOS PAC ID: 1759677172 Enrollment ID: I20170810000669 |
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 | |
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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 | |
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