GINA MARIE FASANO (NPI# 1255958138) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255958138 |
| Entity Type | Individual |
| Full Name | GINA MARIE FASANO |
| Other Name | GINA MARIE COLLESANO |
| Credential | PA-C |
| Practice Address |
54 Hospital Dr Osage Beach MO 65065-3050 |
| Mailing Address |
369 Lake Dr Sunrise Beach MO 65079-5470 |
| Practice Telephone | 5733488000 |
| Mailing Telephone | 7082097275 |
| Enumeration Date | 2020-06-26 |
| Last Update Date | 2020-07-20 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207XX0005X |
Orthopaedic Surgery Specialization: Sports Medicine |
2020012744 | MO | Allopathic & Osteopathic Physicians |
| Street Address |
54 HOSPITAL DR |
| City | OSAGE BEACH |
| State | MO |
| Zip Code | 65065-3050 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730184151 | Timothy D. Lischwe | Optometrist | 54 Hospital Dr, Osage Beach, MO 65065-3050 | 2005-06-14 |
| 1669070298 | Kimberly Jean Farris | Nurse Practitioner | 54 Hospital Dr, Osage Beach, MO 65065-3050 | 2020-10-15 |
| 1437756608 | Barry Keith Hale | Physical Therapy Assistant | 54 Hospital Dr, Osage Beach, MO 65065-3050 | 2020-10-01 |
| 1427664614 | Samantha J Emry | Nurse Practitioner | 54 Hospital Dr, Osage Beach, MO 65065-3050 | 2020-09-22 |
| 1326665688 | Alyssa Heinsohn | Physical Therapist | 54 Hospital Dr, Osage Beach, MO 65065-3050 | 2020-07-02 |
| 1083230718 | Clarice Rose Schmid | Occupational Therapy Assistant | 54 Hospital Dr, Osage Beach, MO 65065-3050 | 2020-06-18 |
| 1093338857 | James Daniel Calkins | Physical Therapy Assistant | 54 Hospital Dr, Osage Beach, MO 65065-3050 | 2020-05-27 |
| 1205476934 | Krystin Nicole Hall | Speech-Language Pathologist | 54 Hospital Dr, Osage Beach, MO 65065-3050 | 2020-01-10 |
| 1144868209 | Kristen Kay Lee | Speech-Language Pathologist | 54 Hospital Dr, Osage Beach, MO 65065-3050 | 2019-12-19 |
| 1073151254 | Laura Davis | Speech-Language Pathologist | 54 Hospital Dr, Osage Beach, MO 65065-3050 | 2019-12-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437778859 | Suzanne Marie Harris | Social Worker | 1191 State Highway Kk, Suite 101, Osage Beach, MO 65065 | 2020-04-15 |
| 1982172342 | Arrowhead Retirement Operations LLC | Skilled Nursing Facility | 6100 Arrowhead Drive, Osage Beach, MO 65065 | 2018-11-05 |
| 1245723337 | William T Mcfail | Counselor | 1191 State Hwy Kk, Suite 101, Osage Beach, MO 65065 | 2018-06-13 |
| 1588102263 | Jennifer Kiske | Physical Therapist | 5780 Osage Beach Parkway, Ste 220, Osage Beach, MO 65065 | 2017-02-02 |
| 1700207586 | Brenda Renee Spies | Pharmacist | 4252 Osage Beach Parkway, Osage Beach, MO 65065 | 2013-12-23 |
| 1154668465 | Paige Hedgpath Od, PC | Optometrist | 4645g Osage Beach Parkway, Osage Beach, MO 65065 | 2013-01-07 |
| 1649548330 | Missouri Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 300 Kestrel Lane, Lake Ozark, MO 65065 | 2011-12-08 |
| 1437399821 | Melissa Nicole Morgan | Physical Therapy Assistant | 5177 Vicus Castri, Osage Beach, MO 65065 | 2009-02-25 |
| 1730330911 | Raymond Don Baker | Preventive Medicine | 5476 Stone Ledge Cir, Osage Beach, MO 65065 | 2008-10-06 |
| 1457514259 | Lake Family Dentistry | Dentist | 1037 Palisades Blvd Ste 9, Osage Beach, MO 65065 | 2008-07-02 |
| Find all providers in zip 65065 | ||||
| Taxonomy Code | 207XX0005X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Sports Medicine |
| An orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, training and fitness, athletic performance and the impact of dietary supplements, pharmaceuticals, and nutrition on performance and health, coordination of care within the team setting utilizing other health care professionals, field evaluation and management, soft tissue biomechanics and injury healing and repair. Knowledge and understanding of the principles and techniques of rehabilitation, athletic equipment and orthotic devices enables the specialist to prevent and manage athletic injuries. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton changed, source changed] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. ACGME Accredited Program Requirements: 1 year GME in the specialty + 5 years of Orthopaedic Surgery for a total of 6 years |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184018632 | Christopher Amundsen | Orthopaedic Surgery | 448 State Highway 248, Branson, MO 65616 | 2015-03-23 |
| 1033326137 | Luke S Choi | Orthopaedic Surgery | 14285 N. Outer Forty Rd, Suite 200, Chesterfield, MO 63195-0000 | 2007-05-17 |
| 1134344922 | Scott Geoffrey Kaar | Orthopaedic Surgery | U21 S. New Ballas Rd, Ste 3005 B, St Louis, MO 63141 | 2007-04-16 |
| 1467533372 | Gpaletta Orthopedic Consulting, LLC | Orthopaedic Surgery | 14825 S. Outer Forty Rd, Suite 200, Chesterfield, MO 63017 | 2006-10-18 |
| 1013015106 | Allen G Adams | Orthopaedic Surgery | 904 Edmond St, Saint Joseph, MO 64501-2702 | 2006-09-20 |
| 1891728051 | Jody T Jachna | Orthopaedic Surgery | 400 1st Capitol Dr Ste 100, Saint Charles, MO 63301-2881 | 2006-07-09 |
| 1487623260 | Douglas W Kiburz | Orthopaedic Surgery | 2301 S Ingram Ave, Sedalia, MO 65301-8121 | 2006-03-15 |
| 1497726566 | Crane Clinic for Sports Performance | Orthopaedic Surgery | 219 Chesterfield Towne Ctr, Chesterfield, MO 63005-1257 | 2006-01-27 |
| 1124009212 | Christopher M Miller | Orthopaedic Surgery | 3555 S National Ave, Springfield, MO 65807-7310 | 2005-11-07 |
| 1144768912 | Joint Health LLC | Orthopaedic Surgery | 633 Emerson Rd, Suite 10, Creve Coeur, MO 63141-6739 | 2017-02-01 |
| Find all providers with the same taxonomy | ||||
| City | OSAGE BEACH |
| Zip Code | 65065 |
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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.