MIDWEST HEALTH GROUP CONVENIENT CARE, LLC (NPI# 1265987853) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265987853 |
| Entity Type | Organization |
| Organization Name | MIDWEST HEALTH GROUP CONVENIENT CARE, LLC |
| Other Organization Name | MIDWEST CONVENIENT CARE |
| Practice Address |
55 Nesbit Dr Bonne Terre MO 63628-1353 |
| Practice Telephone | 5733581700 |
| Practice Fax Number | 5733581702 |
| Mailing Telephone | 5733581700 |
| Mailing Fax Number | 5733581702 |
| Enumeration Date | 2016-08-24 |
| Last Update Date | 2016-08-24 |
| Authorized Official Name | MRS. MARY ELIZABETH CHANDLER (MANAGER) |
| Authorized Official Telephone | 5733581700 |
| Authorized Official Credential | FNP-C |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332900000X | Non-Pharmacy Dispensing Site | Suppliers |
| Other Name | Type Code |
|---|---|
| Midwest Convenient Care | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861948697 | Midwest Health Group Convenient Care, LLC | Non-Pharmacy Dispensing Site | 123 N Mine La Motte St, Fredericktown, MO 63645-1201 | 2016-08-31 |
| 1982057501 | Midwest Health Group Convenient Care, LLC | Non-Pharmacy Dispensing Site | 550 Maple Valley Dr, Farmington, MO 63640-1981 | 2016-07-19 |
| Street Address |
55 NESBIT DR |
| City | BONNE TERRE |
| State | MO |
| Zip Code | 63628-1353 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851342950 | Leisa Jan Blue | Nurse Practitioner | 55 Nesbit Dr, Bonne Terre, MO 63628-1353 | 2006-05-13 |
| 1356982896 | Michelle Renee Rodriguez-miller | Nurse Practitioner | 55 Nesbit Dr, Bonne Terre, MO 63628-1353 | 2019-10-07 |
| 1073169363 | Rachel Ann Francis | Nurse Practitioner | 55 Nesbit Dr, Bonne Terre, MO 63628-1353 | 2019-08-13 |
| 1972159341 | April Brannum | Family Medicine | 55 Nesbit Dr, Bonne Terre, MO 63628-1353 | 2019-08-12 |
| 1578080099 | Tonya Ranee Herbst | Nurse Practitioner | 55 Nesbit Dr, Bonne Terre, MO 63628-1353 | 2017-08-25 |
| 1013247147 | Taylor Michael Lumsden | Physical Therapist | 55 Nesbit Dr, Bonne Terre, MO 63628-1353 | 2010-01-13 |
| 1104071935 | Bonne Terre Health Clinic LLC | Family Medicine | 55 Nesbit Dr, Bonne Terre, MO 63628-1353 | 2008-11-20 |
| 1841398773 | Farmington Clinic Company LLC | Clinic/Center | 55 Nesbit Dr, Bonne Terre, MO 63628-1353 | 2006-09-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437675477 | Kybama, Inc | Residential Treatment Facility, Emotionally Disturbed Children | 12729 Stoney Point Rd, Bonne Terre, MO 63628 | 2017-08-22 |
| 1295092500 | Jak Properties Inc | In Home Supportive Care | 522 Benham St, Suite B, Bonne Terre, MO 63628 | 2012-04-12 |
| 1013121599 | Joseph Richard Engel | Dentist | 20 W Johnson St, Bonne Terre, MO 63628 | 2007-05-10 |
| 1215093844 | Debra Long Morgan | Dentist | 20 West Johnson Street, Bonne Terre, MO 63628 | 2006-12-28 |
| 1497811459 | Robert Oliver Greenwald | Dentist | #20 W Johnson, Bonne Terre, MO 63628 | 2006-12-27 |
| 1255964508 | American Nursing & Rehab LLC | Assisted Living Facility | 10 Lake Drive, Bonne Terre, MO 63628 | 2020-02-14 |
| 1962679746 | Robert O Greenwald Dds PC | Dentist | #20 W Johnson, Bonne Terre, MO 63628 | 2008-05-12 |
| 1427045004 | Pairat Vibulakaopun | Internal Medicine | 527 Benham St, Bonne Terre, MO 63628-1205 | 2005-09-29 |
| 1124014030 | Kenny Ratana | Radiology | 527 Benham St # B, Bonne Terre, MO 63628-1205 | 2005-09-26 |
| 1669017315 | Patricia Ann Peterson | Nurse Practitioner | 527 Benham St, Bonne Terre, MO 63628-1205 | 2019-11-15 |
| Find all providers in zip 63628 | ||||
| Taxonomy Code | 332900000X |
| Grouping | Suppliers |
| Classification | Non-Pharmacy Dispensing Site |
| A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.) |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558909150 | Dedicated Missouri Holding, LLC | Non-Pharmacy Dispensing Site | 3649 Page Blvd, Saint Louis, MO 63113-3807 | 2019-12-13 |
| 1568945103 | Ficom | Non-Pharmacy Dispensing Site | 1308 North Glenstone Avenue, Springfield, MO 65802 | 2018-09-10 |
| 1033629761 | Cerner Health Connections, Inc | Non-Pharmacy Dispensing Site | 6601 Winchester Ave Ste 240, Kansas City, MO 64133-4657 | 2017-10-09 |
| 1861948697 | Midwest Health Group Convenient Care, LLC | Non-Pharmacy Dispensing Site | 123 N Mine La Motte St, Fredericktown, MO 63645-1201 | 2016-08-31 |
| 1114291515 | Burns & Mcdonnell | Non-Pharmacy Dispensing Site | 9400 Ward Pkwy, Kansas City, MO 64114-3319 | 2012-03-02 |
| 1811131956 | U.S. Optical | Non-Pharmacy Dispensing Site | 2346 S Campbell Ave, Springfield, MO 65807-2972 | 2009-04-20 |
| 1467661157 | Vitalsurge LLC | Non-Pharmacy Dispensing Site | 702 W 42nd St, Joplin, MO 64804-4564 | 2007-05-21 |
| 1477767259 | Ion Pharmaceuticals | Non-Pharmacy Dispensing Site | 2190 1st Capitol Dr, Saint Charles, MO 63301-5804 | 2007-05-10 |
| 1184703852 | Orthopedic Associates | Non-Pharmacy Dispensing Site | 1050 Des Peres Rd, Ste 100, Saint Louis, MO 63131-2042 | 2006-11-03 |
| 1790317402 | Dedicated Missouri Holding, LLC | Non-Pharmacy Dispensing Site | 175 N Oaks Plz, Saint Louis, MO 63121-2925 | 2020-02-10 |
| Find all providers with the same taxonomy | ||||
| City | BONNE TERRE |
| Zip Code | 63628 |
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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.