SEAN P. GANNUTZ (NPI# 1174993711) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174993711 |
| Entity Type | Individual |
| Full Name | SEAN P. GANNUTZ |
| Credential | PA-C |
| Practice Address |
151 Johnstown Dr Rogersville MO 65742-9366 |
| Mailing Address |
Po Box 4046 Springfield MO 65808-4046 |
| Practice Telephone | 4172692252 |
| Practice Fax Number | 4172692259 |
| Mailing Telephone | 4172695712 |
| Mailing Fax Number | 4172697567 |
| Enumeration Date | 2015-09-25 |
| Last Update Date | 2018-10-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 2015032410 | MO | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | PENDING | 05 |
| Street Address |
151 JOHNSTOWN DR |
| City | ROGERSVILLE |
| State | MO |
| Zip Code | 65742-9366 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164487070 | Donna F Harper | Family Medicine | 151 Johnstown Dr, Rogersville, MO 65742-9366 | 2006-04-20 |
| 1528003746 | Lester E Cox Medical Centers | Family Medicine | 151 Johnstown Dr, Rogersville, MO 65742-9366 | 2006-06-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851953103 | Sara L Newhard | Counselor | 3955 S. Farm Road 223, Rogersville, MO 65742 | 2019-07-07 |
| 1235653551 | Madison Marie Parson | Physical Therapy Assistant | 586 Cottonwood Rd., Rogersville, MO 65742 | 2017-07-28 |
| 1548612062 | Jonathan Price | Student in an Organized Health Care Education/Training Program | 5649 South Highway 125, Rogersville, MO 65742 | 2016-07-08 |
| 1366790941 | Pediatric Neuropsychological Services, LLC | Clinical Neuropsychologist | 175 S. Marshall, Suite G, Rogersville, MO 65742 | 2012-08-29 |
| 1245426436 | Lori Ann Cole | Occupational Therapist | 113 E. Center St., Ozark Therapy Institute, Rogersville, MO 65742 | 2007-09-20 |
| 1942335203 | Sgoh Acquisition Inc | Clinic/Center | 101 South Main, Rogersville, MO 65742 | 2007-02-23 |
| 1922190842 | Bret E Herrman | Chiropractor | 319 S Main, Ste F, Rogersville, MO 65742-0228 | 2006-09-28 |
| 1952804668 | Equi-librium Therapy Center | Clinic/Center | 1148 S Courtney Ln, Rogersville, MO 65742-4501 | 2018-03-09 |
| 1134167331 | Theodore Brooke Nelson | Physical Therapist | 5764 S Farm Road 203, Rogersville, MO 65742-6436 | 2006-06-02 |
| 1598998775 | Nelson Physical Therapy and Rehab, P.C. | Physical Therapist | 5764 S Farm Road 203, Rogersville, MO 65742-6436 | 2009-09-03 |
| Find all providers in zip 65742 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104335553 | Rebeka Kaye Skelton | Physician Assistant | 4307 Highway 66 S, Rogersville, TN 37857-3155 | 2017-09-28 |
| 1902357627 | Chelsey Leeann Babb | Physician Assistant | 4307 Highway 66 S, Rogersville, TN 37857-3155 | 2016-10-18 |
| 1346524865 | Sarah S Kersey | Physician Assistant | 4966 Highway 11w, Rogersville, TN 37857-6028 | 2011-10-03 |
| 1497037550 | Kenneth Byrd | Physician Assistant | 312 Armstrong St, Rogersville, TN 37857-3606 | 2011-09-15 |
| 1477786457 | David Charles Saunders | Physician Assistant | 4307 Highway 66 S, Rogersville, TN 37857-3155 | 2009-08-25 |
| 1881629244 | Jennifer Teagarden | Physician Assistant | 140 Church St, Rogersville, PA 15359-1001 | 2006-07-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639779341 | Andrew Hecht | Physician Assistant | 13131 Tesson Ferry Rd Ste 105, Saint Louis, MO 63128-3887 | 2020-10-30 |
| 1396352860 | Alexis Lindsey | Physician Assistant | 5629 Bischoff Ave, Saint Louis, MO 63110-2929 | 2020-09-28 |
| 1194334094 | Olivia Faeth Langley | Physician Assistant | 507 Kenilworth Ln, Ballwin, MO 63011-2433 | 2020-07-27 |
| 1770192759 | Clara Boo Chai | Physician Assistant | General Leonard Wood Army Community Hospital, 4430 Missouri Ave, #1267, Fort Leonard Wood, MO 65473 | 2020-07-27 |
| 1942824339 | Jett Elena Mcguire | Physician Assistant | 2200 Locust St Apt 506, Saint Louis, MO 63103-1532 | 2020-06-02 |
| 1356965602 | Katherine Anne Hill | Physician Assistant | 3619 Whispering Ridge Ln, Saint Louis, MO 63129-2247 | 2020-06-02 |
| 1922629559 | Tiffany Nuno | Physician Assistant | 621 Tipton St, Sullivan, MO 63080-2152 | 2020-05-06 |
| 1477174944 | Sarah Christenson | Physician Assistant | 4515 Walnut St Apt 221d, Kansas City, MO 64111-7731 | 2020-05-06 |
| 1326669516 | Kayla Bergmann | Physician Assistant | 58 W Glendale Rd, Saint Louis, MO 63119-4054 | 2020-04-29 |
| 1962023341 | Kaitlin Nicole Sutten | Physician Assistant | 6711 Nw Evelyn St, Kansas City, MO 64151-2115 | 2020-04-27 |
| Find all providers with the same taxonomy | ||||
| City | ROGERSVILLE |
| Zip Code | 65742 |
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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.