ODESSA MEDICAL CLINIC PC (NPI# 1023224904) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023224904 |
| Entity Type | Organization |
| Organization Name | ODESSA MEDICAL CLINIC PC |
| Other Organization Name | BRADLEY L ZINK DO |
| Practice Address |
316 W Us Highway 40 Odessa MO 64076-7445 |
| Practice Telephone | 8162308777 |
| Practice Fax Number | 8162308855 |
| Mailing Telephone | 8162308777 |
| Mailing Fax Number | 8162308855 |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2009-11-17 |
| Authorized Official Name | DR. BRADLEY LEONARD ZINK (PRESIDENT) |
| Authorized Official Telephone | 8162308777 |
| Authorized Official Credential | D.O. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | DOR9F95 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | BCBSKC INDIVIDUAL PROV | 12844049 | 01 |
| MO | MEDICARE GROUP NUMBER | M140000 | 01 |
| MO | BCBSKC GRP NUMBER | 31334013 | 01 |
| Other Name | Type Code |
|---|---|
| Bradley L Zink DO | Doing Business As Name - Organization |
| Street Address |
316 W US HIGHWAY 40 |
| City | ODESSA |
| State | MO |
| Zip Code | 64076-7445 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023409844 | Danielle Hammontree | Nurse Practitioner | 316 W Us Highway 40, Odessa, MO 64076-7445 | 2015-02-16 |
| 1396150496 | Sonja Jeanne Bolling | Nurse Practitioner | 316 W Us Highway 40, Odessa, MO 64076-7445 | 2014-06-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548823966 | Bethany Jeanette Foss | Nurse Practitioner | 1280 W 40 Hwy, Odessa, MO 64076 | 2019-04-22 |
| 1619216231 | Heather N Begemann | Nurse Practitioner | 1280 West 40 Hwy, Odessa, MO 64076 | 2013-02-01 |
| 1558640334 | Linda Lou Proctor | Registered Nurse | 1278 Old Us 40 Hwy, Odessa, MO 64076 | 2011-08-10 |
| 1730499104 | Pamela Joyce Miller | Counselor | 406 A N. 4th Street, Odessa, MO 64076 | 2010-10-19 |
| 1225004781 | Richard Joseph Humble | Counselor | 406a N 4th, Odessa, MO 64076 | 2006-02-24 |
| 1568962611 | Tina Marie Davis | Nurse Practitioner | 1280 West 40 Hwy, Odessa, MO 64076 | 2018-02-15 |
| 1740701697 | Leslie Gleason | Counselor | 1278 W Us Highway 40, Odessa, MO 64076 | 2017-06-30 |
| 1982080008 | Danielle Fera | Counselor | 1278 W Us Highway 40, Odessa, MO 64076 | 2015-07-31 |
| 1184979940 | Lucas Paul Taylor | Counselor | 1278 W Us Highway 40, Odessa, MO 64076 | 2012-07-18 |
| 1093893893 | Missouri Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 101 S 2nd St, Odessa, MO 64076 | 2006-11-01 |
| Find all providers in zip 64076 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376150102 | Paul Joseph Baquirin | Family Medicine | 1403 E Century Ave, Odessa, TX 79762-7743 | 2020-09-25 |
| 1972868974 | Carehere LLC | Family Medicine | 2330 W 10th St, Odessa, TX 79763-3782 | 2012-07-06 |
| 1376807362 | Mavis Twum-barimah | Family Medicine | 6030 W University Blvd, Odessa, TX 79764-8530 | 2012-06-25 |
| 1962761791 | Marvin Ryan Harvey | Family Medicine | 701 W 5th St Ste 3174, Odessa, TX 79763 | 2012-05-14 |
| 1841576378 | Ashley Burdex | Family Medicine | 6030 W University, Odessa, TX 79761 | 2011-10-28 |
| 1043517204 | Scotty Ortega Pa | Family Medicine | 4415 Hinkle St, Odessa, TX 79762-4626 | 2011-02-23 |
| 1265763130 | Robert James Ailes | Family Medicine | 16641 Ivy Lake Dr, Odessa, FL 33556-6019 | 2010-01-16 |
| 1609020452 | Leo Villaroman, Md, Pa | Family Medicine | 501 Golder Ave, Suite 203, Odessa, TX 79761-4411 | 2008-11-06 |
| 1568640365 | John Garcia Md Pa | Family Medicine | 601 East 7th Street, Odessa, TX 79761 | 2008-02-04 |
| 1568680593 | Bhavana Yerabati Mocherla | Family Medicine | 701 West 5 Street, Texas Tech University Health Sciences Center Department, Odessa, TX 79763-4368 | 2007-04-23 |
| Find all providers in ODESSA | ||||
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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.