1. Home
  2. Directory
  3. Missouri
  4. Saint Louis
  5. Student In An Organized Health Care Education Training Program
  6. NPI Profile

SHAMMAH KODJO-SOROH MD
NPI 1164370458
Student in an Organized Health Care Education/Training Program in Saint Louis, MO

Active since March 20, 2026PECOS Enrolled
1465 S GRAND BLVD, SAINT LOUIS, MO 63104(314) 577-5600 Get Directions Write a Review

NPPES record last updated: March 20, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Shammah Kodjo-soroh Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHAMMAH KODJO-SOROH MD (NPI 1164370458) is an individual student in an organized health care education/training program in Saint Louis, Missouri and active in the NPI registry since March 2026. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1164370458
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameSHAMMAH KODJO-SOROHCredential: MD
Location Address1465 S GRAND BLVDSaint Louis, MO 63104-1003
Mailing Address1465 S Grand BlvdSaint Louis, MO 63104-1003 · (314) 577-5600
Phone(314) 577-5600
Sole ProprietorNo
Enumeration DateMarch 20, 2026
NPPES CertifiedMarch 20, 2026
✔ NPI 1164370458 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
1465 S GRAND BLVD, Saint Louis, MO 63104
Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Shammah Kodjo-soroh Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. SARAH MARGARET HANLY PH.D.
Psychologist (Clinical)
1465 S GRAND BLVD
SAINT LOUIS, MO 63104
St. Louis City (314) 577-5667
KAVIPRIYA KOMESWARAN
Pediatrics (Pediatric Critical Care Medicine)
1465 S GRAND BLVD
SAINT LOUIS, MO 63104
St. Louis City (314) 617-2000
ALEXIS HAAS STEWART
Anesthesiologist Assistant
1465 S GRAND BLVD
SAINT LOUIS, MO 63104
St. Louis City (314) 977-5700
NATALIE DRURY RD, LD
Dietitian, Registered (Nutrition, Pediatric)
1465 S GRAND BLVD
SAINT LOUIS, MO 63104
St. Louis City (314) 577-5387
TIMOTHY J KUTZ MD
Pediatrics (Child Abuse Pediatrics)
1465 S GRAND BLVD
SAINT LOUIS, MO 63104
St. Louis City (314) 268-6406
CHRISTOPHER SALLEE MD
Pediatrics
1465 S GRAND BLVD
ST. LOUIS, MO 63104
St. Louis City (314) 577-1607
AMBER GRANA DO
Pediatrics (Pediatric Critical Care Medicine)
1465 S GRAND BLVD, DIVISION OF PEDIATRIC CRITICAL CARE
SAINT LOUIS, MO 63104
St. Louis City (314) 577-5695
DR. ETHAN EMIL PFEIFER MD
Student in an Organized Health Care Education/Training Program
1465 S GRAND BLVD
SAINT LOUIS, MO 63104
St. Louis City (314) 268-4070

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shammah Kodjo-soroh's NPI number?

The NPI number for Shammah Kodjo-soroh is 1164370458. It was assigned to this individual provider in the NPPES registry on March 20, 2026.

Where is Shammah Kodjo-soroh located?

Shammah Kodjo-soroh practices at 1465 S Grand Blvd, Saint Louis, MO 63104. The listed phone number is (314) 577-5600.

What is Shammah Kodjo-soroh's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Shammah Kodjo-soroh enrolled in Medicare?

Yes. Shammah Kodjo-soroh is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Shammah Kodjo-soroh was last updated on March 20, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.