Taxonomy Code 363A00000X(363a00000x)
Physician Assistant. Providers: 12

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Physician Assistant Providers

NPI Name Type Address

1275706913

MRS. PAC MMS Amber Renee Johnson

Individual

12255 De Paul Dr

Suite 460

Bridgeton, MO

1720127012

PA-C Michele L Bena

Individual

12303 Depaul Dr.

Bridgeton, MO

1154639318

MS. PA Jennifer Cafi

Individual

12303 De Paul Dr

Bridgeton, MO

1396796041

PA-C Paul J Diesfeld

Individual

12349 De Paul Dr Ste 100

Bridgeton, MO

1437590437

PA Courtney C Grodie

Individual

12349 De Paul Dr

Bridgeton, MO

1356393961

MRS. PA-C Lynn M Robbins

Individual

12349 De Paul Dr Ste 100

Bridgeton, MO

1013548767

MR. PA Blessing Kudakwashe Tupiri

Individual

12266 De Paul Dr Ste 205

Bridgeton, MO

1679968135

PA Elizabeth Bokermann

Individual

12349 De Paul Dr Ste 100

Bridgeton, MO

1174144828

Daniel Zackary Souvannarath

Individual

12266 De Paul Dr Ste 310

Bridgeton, MO

1700340320

PA Courtney M Sumners

Individual

12266 De Paul Dr Ste 205

Bridgeton, MO

1750741351

MS. PA-C Elana Ruth Hacker

Individual

12303 De Paul Dr

Bridgeton, MO

1760946669

PA Shannon Michelle Root Bast

Individual

12266 De Paul Dr Ste 205

Bridgeton, MO

How to obtain, renew, or terminate an NPI

Every health care provider, whether it’s a hospital, pharmacy, or individual specialist, must obtain their own NPI number. This identification number is unique and is assigned upon application. In tod...

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Taxonomy Code 363A00000X
Display Name Physician Assistant
Taxonomy Group Physician Assistants & Advanced Practice Nursing Providers
Taxonomy Classification Physician Assistant
Definition A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
Effective Date September 30, 2009
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Physician Assistant Codes

Medical Physician Assistant

363AM0700X • providers: 36,490

Surgical Physician Assistant

363AS0400X • providers: 16,971