Individual provider Active NPI

Vandana Dalton, M.D.

  • Obstetrics & Gynecology Physician
  • Fenton, MO
National Provider Identifier
1508126889
Registry record updated Oct 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
2016014161 Issued in MO
Practice address
714 Gravois Rd
Fenton, MO 63026-7723
Phone
(636) 717-6775
Fax
(636) 717-6755
NPI assigned
May 21, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 2016014161 MO Primary

Addresses

Primary practice location

714 Gravois Rd
Fenton, MO 63026-7723

Mailing address

714 Gravois Rd
Ste 115
Fenton, MO 63026-7723
Phone (314) 543-6985

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160822000314 MO Practitioner - Obstetrics/Gynecology 1951538792 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Saint Louis University School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic East CommunitiesGroup PAC ID 7214827922, 573 clinicians

Practice addresses (Care Compare)

621 S New Ballas Rd
Suite 4005B
Saint Louis, MO 63141-8268
Phone (314) 251-5016

621 S New Ballas Rd
Suite 4017B
Saint Louis, MO 63141-8269
Phone (314) 872-9192

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2016014161MOMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic East Communities Obstetrics & Gynecology CurrentSince Jan 1, 2020 Accepting new patients
Mercy Clinic East Communities CurrentSince Jan 1, 2020 Accepting new patients
Mercy Hospitals East Communities Past Accepting new patients

Locations

714 Gravois Rd
Ste 115
Fenton, MO 63026
Phone (636) 717-6775

621 S New Ballas Rd
Ste 4017B
Saint Louis, MO 63141
Phone (314) 872-9192

9735 Landmark Parkway Dr
Ste 200
Saint Louis, MO 63127
Phone (314) 525-1887

621 S New Ballas Rd
Ste 2009B
Saint Louis, MO 63141
Phone (314) 251-6062

5425 Southfield Ctr
Saint Louis, MO 63123
Phone (314) 543-5258

621 S New Ballas Rd
Ste 189A
Saint Louis, MO 63141
Phone (314) 251-6335

621 S New Ballas Rd
Ste 4005B
Saint Louis, MO 63141
Phone (314) 251-5016

Interoperability endpoints

  • Direct secure messaging: vdalton992402@directc.mercy.net

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1337558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476230400000",
    "number": "1508126889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "714 GRAVOIS RD",
            "address_2": "STE 115",
            "city": "FENTON",
            "state": "MO",
            "postal_code": "630267723",
            "telephone_number": "314-543-6985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "714 GRAVOIS RD",
            "city": "FENTON",
            "state": "MO",
            "postal_code": "630267723",
            "telephone_number": "636-717-6775",
            "fax_number": "636-717-6755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DALTON",
        "first_name": "VANDANA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-21",
        "last_updated": "2016-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MO",
            "license": "2016014161",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fenton, MO

Sources for this page

Verify at the official NPI Registry.