MARILEE GREEN BOMAR (NPI# 1013954601) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013954601 |
| Entity Type | Individual |
| Full Name | MARILEE GREEN BOMAR |
| Other Name | MARILEE SUE GREEN |
| Credential | MSN |
| Practice Address |
551 E Southampton Dr Columbia MO 65201-4236 |
| Mailing Address |
Po Box 843966 Kansas City MO 64184-3966 |
| Practice Telephone | 5738847733 |
| Practice Fax Number | 5738826228 |
| Mailing Telephone | 5738843300 |
| Mailing Fax Number | 5738840943 |
| Enumeration Date | 2006-06-01 |
| Last Update Date | 2019-05-03 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363L00000X | Nurse Practitioner | 128845 | MO | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 364SG0600X |
Clinical Nurse Specialist Specialization: Gerontology |
128845 | MO | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 420750200 | 05 |
| Street Address |
551 E SOUTHAMPTON DR |
| City | COLUMBIA |
| State | MO |
| Zip Code | 65201-4236 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588621585 | Kieth W Groh | Emergency Medicine | 551 E Southampton Dr, Columbia, MO 65201-4236 | 2006-04-26 |
| 1194341560 | Melanie Oler | Family Medicine | 551 E Southampton Dr, Columbia, MO 65201-4236 | 2020-06-22 |
| 1821614272 | Daniel Lyon | Family Medicine | 551 E Southampton Dr, Columbia, MO 65201-4236 | 2020-06-22 |
| 1891311254 | Seth Mobley | Family Medicine | 551 E Southampton Dr, Columbia, MO 65201-4236 | 2020-06-22 |
| 1265058630 | Nicole Seddon | Family Medicine | 551 E Southampton Dr, Columbia, MO 65201-4236 | 2020-06-22 |
| 1417573874 | Colbert Nelson | Family Medicine | 551 E Southampton Dr, Columbia, MO 65201-4236 | 2020-06-22 |
| 1245891548 | Oluwatoke Omotola Omiwade | Family Medicine | 551 E Southampton Dr, Columbia, MO 65201-4236 | 2019-06-26 |
| 1194386987 | Cynthia Breanne Lombardo | Family Medicine | 551 E Southampton Dr, Columbia, MO 65201-4236 | 2019-06-24 |
| 1609437490 | Reiana Jo Mahan | Family Medicine | 551 E Southampton Dr, Columbia, MO 65201-4236 | 2019-06-24 |
| 1457912255 | Humza Omar Quadri | Family Medicine | 551 E Southampton Dr, Columbia, MO 65201-4236 | 2019-06-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134688534 | Thomas Havey | Specialist/Technologist | 600 E Stadium Boulevard, Columbia, MO 65201 | 2019-03-15 |
| 1881176121 | Darrea L Green | Nurse Practitioner | 3700 Interstate 70 Dr Se, Columbia, MO 65201 | 2018-09-04 |
| 1073092383 | Andrea L. Lingenfelter | Registered Nurse | 1605 East Broadway, Ste. 100, Columbia, MO 65201 | 2018-08-08 |
| 1144724238 | Angela Marie Richmond | Internal Medicine | 1 Hospital Dr Rm Ma423, Columbia, MO 65201 | 2018-03-22 |
| 1770092892 | Palmer's Home Care, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 701 Hillsdale Road, Columbia, MO 65201 | 2017-09-20 |
| 1205358710 | Mitchell E Swee | Specialist/Technologist | 600 East Stadium Blvd, Columbia, MO 65201 | 2017-07-17 |
| 1659815470 | Colleen Jockin | Specialist | 100 Matc, Columbia, MO 65201 | 2016-12-13 |
| 1720535305 | Hannah Garrad | Dietitian, Registered | Columbia 3, 25 Conley Road, Columbia, MO 65201 | 2016-09-01 |
| 1043662570 | Restoration Chiropractic LLC | Chiropractor | 1413 Grindstone Plaza Drive, Columbia, MO 65201 | 2016-07-08 |
| 1306298930 | Taylor John Sirois | Chiropractor | 1413 Grindstone Plaza Dr., Columbia, MO 65201 | 2016-07-07 |
| Find all providers in zip 65201 | ||||
| Taxonomy Code | 364SG0600X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Clinical Nurse Specialist |
| Specialization | Gerontology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750557633 | Karen Cavender Hackmann | Clinical Nurse Specialist | 1 Hospital Dr, Mc11 (dco92.10), Columbia, MO 65212-0001 | 2008-05-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316064199 | Nancy K Stubbs | Clinical Nurse Specialist | 1100 N Industrial Dr, Houston, MO 65483-9407 | 2007-03-25 |
| 1184175085 | Misrak Gebissa | Clinical Nurse Specialist | 9 Sackston Woods Ln, Creve Coeur, MO 63141-8228 | 2016-10-17 |
| 1427479641 | Marsha L. Mcguire | Clinical Nurse Specialist | 3635 Vista Ave, Department of Nursing, Saint Louis, MO 63110-2539 | 2013-12-16 |
| 1013959022 | Linda Graham Crosser | Clinical Nurse Specialist | 4440 Broadway St, Kansas City, MO 64111-3315 | 2006-06-12 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.