MISSOURI MEDICAL PROVIDERS LLC (NPI# 1043817323) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043817323 |
| Entity Type | Organization |
| Organization Name | MISSOURI MEDICAL PROVIDERS LLC |
| Practice Address |
10 Lake Dr Bonne Terre MO 63628-1820 |
| Mailing Address |
2732 Bloomfield Rd Cape Girardeau MO 63703 |
| Practice Telephone | 5733353044 |
| Mailing Telephone | 5733353044 |
| Enumeration Date | 2020-10-08 |
| Last Update Date | 2020-10-08 |
| Authorized Official Name | SHAFIQ MALIK (ORGANIZER) |
| Authorized Official Telephone | 5733353044 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
10 LAKE DR |
| City | BONNE TERRE |
| State | MO |
| Zip Code | 63628-1820 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144301144 | St Joe Manor Inc | Skilled Nursing Facility | 10 Lake Dr, Bonne Terre, MO 63628-1820 | 2006-10-17 |
| 1770190050 | Tiffany Arnold | Nurse Practitioner | 10 Lake Dr, Bonne Terre, MO 63628-1820 | 2020-09-30 |
| 1477170959 | Np Health of Mo LLC | Physical Medicine & Rehabilitation | 10 Lake Dr, Bonne Terre, MO 63628-1820 | 2020-06-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437675477 | Kybama, Inc | Residential Treatment Facility, Emotionally Disturbed Children | 12729 Stoney Point Rd, Bonne Terre, MO 63628 | 2017-08-22 |
| 1295092500 | Jak Properties Inc | In Home Supportive Care | 522 Benham St, Suite B, Bonne Terre, MO 63628 | 2012-04-12 |
| 1013121599 | Joseph Richard Engel | Dentist | 20 W Johnson St, Bonne Terre, MO 63628 | 2007-05-10 |
| 1215093844 | Debra Long Morgan | Dentist | 20 West Johnson Street, Bonne Terre, MO 63628 | 2006-12-28 |
| 1497811459 | Robert Oliver Greenwald | Dentist | #20 W Johnson, Bonne Terre, MO 63628 | 2006-12-27 |
| 1255964508 | American Nursing & Rehab LLC | Assisted Living Facility | 10 Lake Drive, Bonne Terre, MO 63628 | 2020-02-14 |
| 1962679746 | Robert O Greenwald Dds PC | Dentist | #20 W Johnson, Bonne Terre, MO 63628 | 2008-05-12 |
| 1427045004 | Pairat Vibulakaopun | Internal Medicine | 527 Benham St, Bonne Terre, MO 63628-1205 | 2005-09-29 |
| 1124014030 | Kenny Ratana | Radiology | 527 Benham St # B, Bonne Terre, MO 63628-1205 | 2005-09-26 |
| 1669017315 | Patricia Ann Peterson | Nurse Practitioner | 527 Benham St, Bonne Terre, MO 63628-1205 | 2019-11-15 |
| Find all providers in zip 63628 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851771646 | Shannon Oaks | Nurse Practitioner | 2727 Highway K, Bonne Terre, MO 63628-3430 | 2015-06-05 |
| 1609949338 | Joann Franklin | Nurse Practitioner | 60 Nesbit Dr Ste D, Bonne Terre, MO 63628-1347 | 2006-11-17 |
| 1578080099 | Tonya Ranee Herbst | Nurse Practitioner | 55 Nesbit Dr, Bonne Terre, MO 63628-1353 | 2017-08-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841899614 | Holly Maria Adams | Nurse Practitioner | 724 Highway H, Neelyville, MO 63954-9206 | 2020-10-22 |
| 1235737982 | Katie Ann Allen | Nurse Practitioner | 24583 Tigger, Saint Robert, MO 65584-3806 | 2020-10-14 |
| 1184221160 | Zachary Wade Orr | Nurse Practitioner | 1622 S 18th St, Saint Louis, MO 63104-2504 | 2020-10-02 |
| 1538766514 | Martha Lorraine Courdin-whitson | Nurse Practitioner | 386 Caudill Way, Branson, MO 65616-8686 | 2020-10-02 |
| 1225645393 | Carlee Rozell | Nurse Practitioner | 2522 Equine Valley Rd, Nixa, MO 65714-6101 | 2020-09-23 |
| 1841806551 | Pamela Louise Smith | Nurse Practitioner | 1605 E Broadway Ste 100, Columbia, MO 65201-8023 | 2020-09-17 |
| 1073128518 | Christen Rincker | Nurse Practitioner | 2343 Hickory St, Saint Louis, MO 63104-2418 | 2020-09-11 |
| 1396357141 | Melissa Ann Lovins-bewley | Nurse Practitioner | 14484 County Road 640, Dexter, MO 63841-8667 | 2020-08-21 |
| 1508477688 | Jessica Nicole Whiteman | Nurse Practitioner | 3110 Duncan St, Saint Joseph, MO 64507-1863 | 2020-08-12 |
| 1790393049 | Kathy Forson | Nurse Practitioner | 1235 E. Cherokee St., Springfield, MO 65804 | 2020-07-22 |
| Find all providers with the same taxonomy | ||||
| City | BONNE TERRE |
| Zip Code | 63628 |
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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.