DR. CORBIN VAN DE WEGE (NPI# 1174713564) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174713564 |
| Entity Type | Individual |
| Full Name | DR. CORBIN VAN DE WEGE |
| Credential | MD |
| Practice Address |
1530 E Republic Rd Springfield MO 65804-6530 |
| Mailing Address |
Po Box 802843 Kansas City MO 64180-2843 |
| Practice Telephone | 4172691362 |
| Practice Fax Number | 4172691372 |
| Mailing Telephone | 4172695712 |
| Mailing Fax Number | 4172697567 |
| Enumeration Date | 2007-07-31 |
| Last Update Date | 2020-05-07 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 2007018558 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | ANTHEM | 623949 | 01 |
| Street Address |
1530 E REPUBLIC RD |
| City | SPRINGFIELD |
| State | MO |
| Zip Code | 65804-6530 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598709693 | Lester E. Cox Medical Centers | Family Medicine | 1530 E Republic Rd, Springfield, MO 65804-6530 | 2006-06-16 |
| 1679099576 | Jennifer N Harp | Nurse Practitioner | 1530 E Republic Rd, Springfield, MO 65804-6530 | 2017-08-22 |
| 1982158580 | Helen Kozlov | Nurse Practitioner | 1530 E Republic Rd, Springfield, MO 65804-6530 | 2016-08-11 |
| 1609329598 | Shara Bryan | Nurse Practitioner | 1530 E Republic Rd, Springfield, MO 65804-6530 | 2016-07-27 |
| 1598145732 | Alexa Martin | Nurse Practitioner | 1530 E Republic Rd, Springfield, MO 65804-6530 | 2015-06-03 |
| 1639482912 | Mimi Propst | Family Medicine | 1530 E Republic Rd, Springfield, MO 65804-6530 | 2010-07-15 |
| 1841466265 | Kate P. Kilgo | Nurse Practitioner | 1530 E Republic Rd, Springfield, MO 65804-6530 | 2008-05-06 |
| 1619153012 | Sarah Billings | Pharmacist | 1530 E Republic Rd, Springfield, MO 65804-6530 | 2008-01-15 |
| 1508928623 | Lester E Cox Medical Centers | Family Medicine | 1530 E Republic Rd, Springfield, MO 65804-6530 | 2006-12-14 |
| 1780784306 | Timothy L. Jones | Family Medicine | 1530 E Republic Rd, Springfield, MO 65804-6530 | 2006-09-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790393049 | Kathy Forson | Nurse Practitioner | 1235 E. Cherokee St., Springfield, MO 65804 | 2020-07-22 |
| 1306498779 | Anne B Summers, LLC | Social Worker | 1310 E. Kingsley St., Ste C, Springfield, MO 65804 | 2019-07-15 |
| 1790241800 | Margaret Mary Hart | Social Worker | 1845 S Rogers Ave, Springfield, MO 65804 | 2019-02-13 |
| 1598254666 | Casey Carr | Optometrist | 1229 E Seminole St Ste 110, Springfield, MO 65804 | 2018-05-04 |
| 1124520697 | Shelby D White | Behavioral Analyst | 1300 E. Bradford Parkway, Springfield, MO 65804 | 2018-03-01 |
| 1316448343 | Karl Lynham | Massage Therapist | 1200 E Woodhurst Dr R300, Springfield, MO 65804 | 2018-02-25 |
| 1699273763 | Leah Wilson | Counselor | 1322 E Woodgate, Springfield, MO 65804 | 2018-01-24 |
| 1295242626 | Matthew Crisp | Physical Therapist | 3252 E Independence St, Springfield, MO 65804 | 2018-01-08 |
| 1518491042 | Crystal Spangler | Dietitian, Registered | 1965 S Fremont Ave Ste 220, Springfield, MO 65804 | 2017-04-11 |
| 1588012033 | Jeffrey Williams | Pharmacist | 1235 E. Cherokee, Springfield, MO 65804 | 2016-05-25 |
| Find all providers in zip 65804 | ||||
| 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 | 65804 |
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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.