GREGORY A ROEBACK (NPI# 1033683354) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033683354 |
| Entity Type | Individual |
| Full Name | GREGORY A ROEBACK |
| Credential | LPC |
| Practice Address |
1 Southtowne Dr Potosi MO 63664-5729 |
| Mailing Address |
Po Box 761 Potosi MO 63664-0761 |
| Practice Telephone | 5734389355 |
| Practice Fax Number | 5734387892 |
| Mailing Telephone | 5734389355 |
| Mailing Fax Number | 5734387892 |
| Enumeration Date | 2019-01-21 |
| Last Update Date | 2020-01-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
002061 | MO | Behavioral Health & Social Service Providers |
| Street Address |
1 SOUTHTOWNE DR |
| City | POTOSI |
| State | MO |
| Zip Code | 63664-5729 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386631596 | Marianne Klemm | Family Medicine | 1 Southtowne Dr, Suite B, Potosi, MO 63664-5729 | 2005-10-03 |
| 1144831124 | Kristin R Jennings | Nurse Practitioner | 1 Southtowne Dr, Potosi, MO 63664-5729 | 2020-08-12 |
| 1124648423 | Penny Kaye Grechus | Nurse Practitioner | 1 Southtowne Dr, Potosi, MO 63664-5729 | 2020-04-16 |
| 1447893003 | Emily Morgan Kelley | Nurse Practitioner | 1 Southtowne Dr, Potosi, MO 63664-5729 | 2019-10-25 |
| 1093367591 | Jill Bleything | Dentist | 1 Southtowne Dr, Potosi, MO 63664-5729 | 2019-07-15 |
| 1336701606 | Kyungsang Lee | Dentist | 1 Southtowne Dr, Potosi, MO 63664 | 2019-07-08 |
| 1992367213 | Shannon Michelle Leftridge | Nurse Practitioner | 1 Southtowne Dr, Potosi, MO 63664-5729 | 2019-07-08 |
| 1205318490 | Terra Renee Graves | Social Worker | 1 Southtowne Dr, Potosi, MO 63664-5729 | 2018-09-04 |
| 1578092797 | Brittany Nicole Helms | Nurse Practitioner | 1 Southtowne Dr, Potosi, MO 63664-5729 | 2017-06-10 |
| 1144756966 | Nicholas Veenstra | Dentist | 1 Southtowne Dr, Potosi, MO 63664-5729 | 2017-05-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083017461 | Carolyn Coyne Maryan | Specialist/Technologist | 400 Mine St., Citadel School, Potosi, MO 63664 | 2014-09-30 |
| 1205073665 | Potosi Chiropractic Life Center | Chiropractor | 502 North Missouri St., Potosi, MO 63664 | 2009-01-07 |
| 1932385952 | Simpelo Medical Clinic, P.C. | Internal Medicine | 108 Frizzell, Suite 6, Potosi, MO 63664 | 2008-01-22 |
| 1760696918 | Brett T Snodgrass | General Practice | 1 Southtowne Dr., Great Mines Health Center, Potosi, MO 63664 | 2007-05-09 |
| 1710032297 | Washington County Handicapped Services Adult Day Health Care | Day Training, Developmentally Disabled Services | 10604 West Highway E, Potosi, MO 63664 | 2007-01-24 |
| 1578629473 | Greenlee Chiropractic Inc. | Chiropractor | Greenlee Chiropractic, 417 East High St, Potosi, MO 63664 | 2006-12-28 |
| 1003981895 | James Daley Robart Jr. | Chiropractor | 912 N Missouri St, Potosi, MO 63664 | 2006-11-21 |
| 1225063407 | Seth Paskon | Internal Medicine | Potosi Medical Clinic, #1 Kwan Plaza, Potosi, MO 63664 | 2006-07-12 |
| 1346295607 | Donna Yates | Nurse Practitioner | 600 Purcell Dr, Suite B, Potosi, MO 63664 | 2006-05-24 |
| 1467424788 | Washington County Memorial Hospital | Clinic/Center | 108 Frizzell Street, Potosi, MO 63664 | 2006-02-02 |
| Find all providers in zip 63664 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073042313 | Gary Selbert | Counselor | 24 Southtowne, Potosi, MO 63664-5729 | 2017-06-09 |
| 1174940647 | Jennifer Diane Kearns | Counselor | 210 E High St, Suite 5, Potosi, MO 63664-1909 | 2014-03-23 |
| 1558640623 | Bobbi J Summers | Counselor | 215 E High St Ste 5, Potosi, MO 63664-1950 | 2011-08-08 |
| 1295784650 | Kristie Lynn Gray | Counselor | 205 State Highway P, Potosi, MO 63664-8486 | 2006-05-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841899374 | Christopher Seigel | Counselor | 5317 Mild Dr, Saint Louis, MO 63129-3109 | 2020-10-26 |
| 1225637838 | Summer Lynn Mcgowan | Counselor | 12040 Southern Breeze, Dexter, MO 63841-2890 | 2020-10-23 |
| 1578162434 | Laquesha Boston | Counselor | 14463 Gravelle Ln, Florissant, MO 63034-2209 | 2020-10-21 |
| 1013515725 | Tim Gravier | Counselor | 770 Aramis Dr, Creve Coeur, MO 63141-7309 | 2020-10-14 |
| 1790383651 | Oasis Counseling and Enrichment | Counselor | 201 Main St Ste 9, Parkville, MO 64152-3645 | 2020-10-13 |
| 1912505082 | Rebekah Sue Weidenaar | Counselor | 503 W Reed St, Moberly, MO 65270-1509 | 2020-10-12 |
| 1407454580 | Ruth A Stoan | Counselor | 1308 W Waldo Ave, Independence, MO 64050-2544 | 2020-10-12 |
| 1679170971 | Avery C Lough | Counselor | 627 E Springfield St, Saint James, MO 65559-1655 | 2020-10-08 |
| 1245837921 | Wendy Velicer | Counselor | 208 N Central Ave Ste D, Eureka, MO 63025-1850 | 2020-10-06 |
| 1730786740 | Julie Lynn Perkins | Counselor | 26394 Highway C, Salem, MO 65560-8655 | 2020-10-02 |
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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.