MISSOURI STATE UNIVERSITY (NPI# 1073600334) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073600334 |
| Entity Type | Organization |
| Organization Name | MISSOURI STATE UNIVERSITY |
| Other Organization Name | BILL AND LUCILLE MAGERS FAMILY HEALTH AND WELLNESS CENTER |
| Practice Address |
715 S Florence Springfield MO 65897 |
| Mailing Address |
901 S National Missouri State University Springfield MO 65897-0001 |
| Practice Telephone | 4178364000 |
| Practice Fax Number | 4178364133 |
| Mailing Telephone | 4178364000 |
| Mailing Fax Number | 4178364133 |
| Enumeration Date | 2006-10-06 |
| Last Update Date | 2018-11-01 |
| Authorized Official Name | CLARA LYNETTE WALKER (BUSINESS OFFICE COORDINATOR) |
| Authorized Official Telephone | 4178364040 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103T00000X | Psychologist | Behavioral Health & Social Service Providers | ||
| N | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians | ||
| N | 207X00000X | Orthopaedic Surgery | Allopathic & Osteopathic Physicians | ||
| N | 133N00000X | Nutritionist | Dietary & Nutritional Service Providers | ||
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
Allopathic & Osteopathic Physicians | ||
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians | ||
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Bill and Lucille Magers Family Health and Wellness Center | Other Name - Individual/Organization |
| Magers Health and Wellness Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477893907 | Missouri State University | Clinic/Center | 1630 N Jefferson Ave, Springfield, MO 65803-2819 | 2013-02-20 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | MISSOURI STATE UNIVERSITY FOUNDATION | 300 S Jefferson Ave. Suite 100, Springfield, MO 65806-2211 |
| Street Address |
715 S FLORENCE |
| City | SPRINGFIELD |
| State | MO |
| Zip Code | 65897 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700891330 | Taylor Health Center | Pharmacy | 715 S Florence, Springfield, MO 65897-0001 | 2006-07-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467051516 | Kangjun Lee | Specialist/Technologist | 901 S. National Ave., Springfield, MO 65897 | 2020-10-20 |
| 1134743073 | Jared Saylor | Student in an Organized Health Care Education/Training Program | 901 S National Ave, Prof 160, Springfield, MO 65897 | 2020-06-06 |
| 1215597208 | Jangsoo Kim | Student in an Organized Health Care Education/Training Program | 901 S National Ave., Springfield, MO 65897 | 2019-06-20 |
| 1104912542 | Filip John Garrett | Family Medicine | 901 S Nationa Ave, Springfield, MO 65897 | 2006-10-05 |
| 1043306483 | Lawrence Sylvester Shields | Family Medicine | 901 South National Ave, Springfield, MO 65897 | 2006-10-05 |
| 1154677912 | Samantha M Charters | Specialist | 901 S National Ave, Athletic Medical and Rehab, Springfield, MO 65897 | 2012-07-31 |
| 1669543112 | Sally Lynn Hubbard | Family Medicine | 901 S National Ave, Springfield, MO 65897 | 2006-11-13 |
| 1750469102 | Susan Wilson Essman | Family Medicine | 901 South National Avenue, Springfield, MO 65897 | 2006-11-02 |
| 1790862845 | Mary Annette Wardell | Family Medicine | 901 S National Ave, Taylor Health & Wellness Center, Springfield, MO 65897 | 2006-11-01 |
| 1043397169 | Shana Kristin Del Vecchio | Nurse Practitioner | 901 S National Ave, Taylor Health & Wellness Center, Springfield, MO 65897 | 2006-11-01 |
| Find all providers in zip 65897 | ||||
| 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 |
|---|---|---|---|---|
| 1841802592 | Community Health and Wellness Services, Inc. | Family Medicine | 312 Memorial Park Dr, Springfield, PA 19064-1714 | 2020-08-22 |
| 1649815796 | 180 Health Lifestyle Wellness Centers | Family Medicine | 1936 S Glenstone Ave, Springfield, MO 65804-2305 | 2019-11-13 |
| 1790337988 | Aminat Ogun | Family Medicine | 520 N 4th St # 62702, Springfield, IL 62702-5238 | 2019-07-09 |
| 1770076622 | Thomas John Schumann | Family Medicine | 1260 E. Woodlawn Ave, Suite 200, Springfield, PA 19064-3988 | 2018-06-14 |
| 1134648959 | Patricia Derges | Family Medicine | 3259 E Sunshine St Ste Aa, Springfield, MO 65804-2114 | 2017-09-12 |
| 1740704667 | Mercy Management of Sepa | Family Medicine | 1001 Baltimore Pike Ste 109, Springfield, PA 19064-2852 | 2017-08-02 |
| 1083134902 | Trevor Conner | Family Medicine | 1423 N Jefferson Ave, B100, Springfield, MO 65802 | 2017-06-21 |
| 1790215853 | Vincent Marchese | Family Medicine | 1260 E Woodland Ave Ste 200, Springfield, PA 19064-3956 | 2017-06-12 |
| 1184152100 | Canaan Arceneaux | Family Medicine | 1001 Baltimore Pike Ste 106, Springfield, PA 19064-2800 | 2017-06-03 |
| 1063943587 | Cody Stark Rogers | Family Medicine | 1423 N Jefferson Ave # A100, Springfield, MO 65802-1988 | 2017-03-26 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 65897 |
Please comment or provide details below to improve the information on MISSOURI STATE UNIVERSITY.
| 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.