OZARKS MEDICAL CENTER (NPI# 1154838209) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154838209 |
| Entity Type | Organization |
| Organization Name | OZARKS MEDICAL CENTER |
| Other Organization Name | OZARKS MEDICAL CENTER PEDIATRICS |
| Practice Address |
312 N Kentucky Ave West Plains MO 65775 |
| Mailing Address |
Po Box 1100 West Plains MO 65775-1100 |
| Practice Telephone | 4172577076 |
| Practice Fax Number | 4172571417 |
| Mailing Telephone | 4172577076 |
| Mailing Fax Number | 4172571417 |
| Enumeration Date | 2018-01-10 |
| Last Update Date | 2020-08-18 |
| Authorized Official Name | BARRYLYN ULMANIS (PROVIDER ENROLLMENT COORDINATOR) |
| Authorized Official Telephone | 4172576792 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QR1300X |
Clinic/Center Specialization: Rural Health |
174-59 | MO | Ambulatory Health Care Facilities |
| Y | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Ozarks Medical Center Family Medicine and Pediatrics | Doing Business As Name - Organization |
| Ozarks Medical Center Pediatrics | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598373359 | Ozarks Medical Center | Clinic/Center | Omc/zizzer Clinic, 1013 College Street, West Plains, MO 65775 | 2020-07-17 |
| 1427526565 | Ozarks Medical Center | Clinic/Center | 201 West High Street, Suite 2, Willow Springs, MO 65793 | 2018-11-07 |
| 1124514476 | Ozarks Medical Center | Clinic/Center | 201 West High Street, Suite 2, Willow Springs, MO 65793 | 2018-07-10 |
| 1780959684 | Ozarks Medical Center | Pharmacy | 18 Parkway Center, West Plains, MO 65775 | 2012-03-12 |
| 1750680146 | Ozarks Medical Center | Internal Medicine | 1115 Alaska St Ste 215, West Plains, MO 65775-2014 | 2011-03-24 |
| 1326213406 | Ozarks Medical Center | Ambulance | Hc 1 Box 31, Gainesville, MO 65655-9601 | 2008-04-29 |
| 1871768952 | Ozarks Medical Center | Ambulance | 203 Front St, Thayer, MO 65791-1220 | 2008-04-29 |
| 1679600936 | Ozarks Medical Center | Clinic/Center | 172 Hwy 62 East, Suite 1, Salem, AR 72576 | 2007-02-27 |
| 1649306002 | Ozarks Medical Center | Clinic/Center | 260 S Main Street, Mammoth Spring, AR 72554-7466 | 2007-02-27 |
| 1730215195 | Ozarks Medical Center | Clinic/Center | 1375 Nettleton Avenue, Thayer, MO 65791 | 2007-02-27 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | OZARKS MEDICAL CENTER | 1100 Kentucky Ave, West Plains, MO 65775-2029 |
| Street Address |
312 N KENTUCKY AVE |
| City | WEST PLAINS |
| State | MO |
| Zip Code | 65775 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528064102 | Joseph William Stafford Jr. | Pediatrics | 312 N Kentucky Ave, West Plains, MO 65775-2073 | 2005-06-28 |
| 1427554617 | Ashlee Marie Smith | Nurse Practitioner | 312 N Kentucky Ave, West Plains, MO 65775-2073 | 2018-04-05 |
| 1124550686 | Bill Stafford, M.d. | Pediatrics | 312 N Kentucky Ave, West Plains, MO 65775-2073 | 2017-04-03 |
| 1730610171 | Bridgette Hendrix | Nurse Practitioner | 312 N Kentucky Ave, West Plains, MO 65775-2073 | 2017-03-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598373359 | Ozarks Medical Center | Clinic/Center | Omc/zizzer Clinic, 1013 College Street, West Plains, MO 65775 | 2020-07-17 |
| 1962958678 | Fanny Ray | Massage Therapist | 1105 Independence Drive, West Plains, MO 65775 | 2016-09-01 |
| 1295184166 | Shaunda Faye Wolfe | Case Manager/Care Coordinator | 2301 K Hwy Apt. 2, West Plains, MO 65775 | 2016-06-10 |
| 1740694009 | Mary Loretta Rogganbuck | Counselor | 1211 Porter Wagoner #23, West Plains, MO 65775 | 2014-06-16 |
| 1548673858 | John Tollenaar | Physical Therapist | 1480 8th Streeet, West Plains, MO 65775 | 2014-06-04 |
| 1861818080 | Raymond Eugene Richardson | Case Manager/Care Coordinator | 1015 Lanton Road, West Plains, MO 65775 | 2014-03-12 |
| 1710309083 | Jared M Sadowitz | Physical Therapist | 1100 Kentucly Ave, West Plains, MO 65775 | 2014-01-06 |
| 1346682184 | Mark L. Dake Dds, Msd and David Sander Dmd, Mds | Dentist | 181 N. Kentucky, Suite 300, West Plains, MO 65775 | 2013-07-22 |
| 1427307024 | Anita M. Nelson | Behavioral Analyst | 8388 Pr 2731, West Plains, MO 65775 | 2012-08-29 |
| 1780959684 | Ozarks Medical Center | Pharmacy | 18 Parkway Center, West Plains, MO 65775 | 2012-03-12 |
| Find all providers in zip 65775 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124550686 | Bill Stafford, M.d. | Pediatrics | 312 N Kentucky Ave, West Plains, MO 65775-2073 | 2017-04-03 |
| 1003278532 | Megan Marie Montague | Pediatrics | 1137 Independence Dr, West Plains, MO 65775-4221 | 2016-03-23 |
| 1578890257 | Garry Erskine Finke | Pediatrics | 1137 Independence Dr, West Plains, MO 65775-4221 | 2009-11-17 |
| 1396836649 | Bill Stafford, M.d. | Pediatrics | 312 N Kentucky St, West Plains, MO 65775-2073 | 2006-09-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114537222 | Natalie Joan Wilson | Pediatrics | 1463 Us Hwy 61, Suite C, Festus, MO 63028-6302 | 2020-08-04 |
| 1538786413 | Melissa An | Pediatrics | 1 Childrens Pl Ste 3s36, Saint Louis, MO 63110-1002 | 2020-06-26 |
| 1033731500 | Jessica N Zeiss | Pediatrics | 981 Highway K, Rhineland, MO 65069-2214 | 2020-05-07 |
| 1538795547 | Virtualnicu | Pediatrics | 10 Warridge Dr, Saint Louis, MO 63124-1166 | 2020-03-21 |
| 1811528656 | Children's Mercy-cockerell and Mcintosh Pediatrics, Inc | Pediatrics | 205 Nw R D Mize Rd Ste 304, Blue Springs, MO 64014-2520 | 2020-01-30 |
| 1134780430 | Jane Reardon | Pediatrics | 8140 Ward Pkwy Ste 275, Kansas City, MO 64114-2032 | 2019-06-26 |
| 1174082887 | Kristen Steinmeyer | Pediatrics | 714 Peace Haven Ct, Saint Louis, MO 63125-5404 | 2019-03-13 |
| 1023574365 | Saint Francis Medical Center | Pediatrics | 2210 Barron Rd Ste 120, Poplar Bluff, MO 63901-1908 | 2019-02-12 |
| 1215402011 | Ayse Bahar Budan Caliskan | Pediatrics | Washington University, St. Louis Children's Hospital, One Children's Place, 4n1, St. Louis, MO 63110-1002 | 2018-10-08 |
| 1336634500 | Martin K Mwangi | Pediatrics | 1 Childrens Place, 3s34, St. Louis, M, MO 63110 | 2018-06-28 |
| Find all providers with the same taxonomy | ||||
| City | WEST PLAINS |
| Zip Code | 65775 |
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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.