DR. HENRY JOSEPH KONZELMANN (NPI# 1225022718) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225022718 |
| Entity Type | Individual |
| Full Name | DR. HENRY JOSEPH KONZELMANN |
| Credential | M.D. |
| Practice Address |
454 N. West Street Perryville MO 63775-4336 |
| Mailing Address |
4046 Oakbrook Rd De Soto MO 63020-5293 |
| Practice Telephone | 5735472536 |
| Mailing Telephone | 2178273114 |
| Enumeration Date | 2005-09-09 |
| Last Update Date | 2016-12-07 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207P00000X | Emergency Medicine | 036095900 | IL | Allopathic & Osteopathic Physicians |
| Y | 207PE0004X |
Emergency Medicine Specialization: Emergency Medical Services |
2013002805 | MO | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | P6438 | TX | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | 01069387A | IN | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | 2013002805 | MO | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | 036095900 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 0360900 | 05 | |
| IL | LICENSE # | 036095900 | 01 |
| Street Address |
454 N. WEST STREET |
| City | PERRYVILLE |
| State | MO |
| Zip Code | 63775-4336 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376144949 | New Life Mission Inn - Missouri | Clinic/Center | 114 W. South, Perryville, MO 63775 | 2020-11-02 |
| 1881211829 | Sarah Jo Cross | Social Worker | 406 S Spring St, Ste 2, Perryville, MO 63775 | 2020-06-25 |
| 1902461908 | Health Care Pharmacy of Perryville, LLC | Pharmacy | 628 N Old St Marys Rd, Perryville, MO 63775 | 2019-05-06 |
| 1710437603 | Danielle Renee Hoeckele | Chiropractor | 1516 Edgemont Blvd Ste 100, Perryville, MO 63775 | 2016-10-04 |
| 1487024956 | Sherry Ann Goshen | Social Worker | 12 N Kings Hwy, Perryville, MO 63775 | 2015-09-28 |
| 1669801353 | Derek Adelman | Physical Therapy Assistant | 206 Hospital Lane, Ste 100, Perryville, MO 63775 | 2013-11-04 |
| 1407158678 | Perry County Memorial Hospital | Ambulance | 434 N West Street, Perryville, MO 63775 | 2010-11-22 |
| 1699928358 | East Missouri Action Agency, Inc. | Clinic/Center | 519 Old St Mary's Rd, Perryville, MO 63775 | 2008-10-28 |
| 1013171115 | Air Evac Ems Inc. | Ambulance | 4801 N Highway 51, Perryville, MO 63775 | 2008-07-17 |
| 1245457241 | Robert Schremp | Physical Therapist | 150 S. Mount Auburn Road, Cape Girardeau, MO 63775 | 2007-04-19 |
| Find all providers in zip 63775 | ||||
| Taxonomy Code | 207PE0004X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| Specialization | Emergency Medical Services |
| An emergency medicine physician who specializes in non-hospital based emergency medical services (e.g., disaster site, accident scene, transport vehicle, etc.) to provide pre-hospital assessment, treatment, and transport patients. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) is issued by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285257105 | City of Perryville | Emergency Medicine | 512 6th St, Perryville, AR 72126 | 2020-05-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962777557 | Blue Springs Emergency Physician Services PC | Emergency Medicine | 201 Nw Rd Mize Road, Blue Springs, MO 64014 | 2012-03-14 |
| 1225160179 | William F Bowman | Emergency Medicine | Heartland Regional Medical Center, 5325 Faraon St, St. Joseph, MO 64506 | 2007-03-09 |
| 1750434999 | Luis Robles | Emergency Medicine | 529 Southwest Blvd, Kansas City, MO 64108-2122 | 2007-01-19 |
| 1134215759 | Guy R Kline | Emergency Medicine | 6141 Oak Creek Dr, Osage Beach, MO 65065-2571 | 2006-10-04 |
| 1053413542 | Michael Eligio Fritsche | Emergency Medicine | 625 Bemis Heights Pl, Saint Charles, MO 63303-1752 | 2006-09-04 |
| 1144251679 | Akeeb Adedokun | Emergency Medicine | 5058 Romaine Spring Dr, Fenton, MO 63026-5868 | 2006-07-05 |
| 1598700684 | Raana J Ponstingl | Emergency Medicine | 3635 Vista At Grand Boulevard, Saint Louis, MO 63110 | 2006-06-20 |
| 1740264670 | Pamela Westerling | Emergency Medicine | 230 Tompkins Court, Troy, MO 63379 | 2005-12-05 |
| 1104432640 | Complex Healthcare of Des Peres LLC | Emergency Medicine | 1032 Old Des Peres Rd, Saint Louis, MO 63131-1865 | 2020-09-21 |
| 1003337858 | William Kells Boland | Emergency Medicine | 1 Barnes-jewish Hospital Plaza, St. Louis, MO 63110 | 2017-07-02 |
| Find all providers with the same taxonomy | ||||
| City | PERRYVILLE |
| Zip Code | 63775 |
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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.