MR. CORY W BLOCKER (NPI# 1396945663) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1396945663 |
Entity Type | Individual |
Full Name | MR. CORY W BLOCKER |
Credential | PNP |
Practice Address |
1200 N One Mile Rd Dexter MO 63841-1000 |
Mailing Address |
3100 Oak Grove Rd Poplar Bluff MO 63901-1908 |
Practice Telephone | 5736247575 |
Mailing Telephone | 5736243600 |
Enumeration Date | 2007-07-24 |
Last Update Date | 2015-10-07 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
148700 | MO | Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MO | MISSOURI PEDIATRIC NURSE | 148700 | 01 |
Street Address |
1200 N ONE MILE RD |
City | DEXTER |
State | MO |
Zip Code | 63841-1000 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1578557872 | Mina K Massey | Family Medicine | 1200 N One Mile Rd, Dexter, MO 63841-1000 | 2005-09-01 |
1255801247 | Kristin Suzanne Wheeler Guethle | Nurse Practitioner | 1200 N One Mile Rd, Dexter, MO 63841-1000 | 2018-12-03 |
1013493865 | Kerri Crawley | Nurse Practitioner | 1200 N One Mile Rd, Dexter, MO 63841-1000 | 2018-07-16 |
1578080214 | Stoddard Emergency Group, LLC | Physician Assistant | 1200 N One Mile Rd, Dexter, MO 63841-1000 | 2017-08-24 |
1851765614 | Leah Legrand | Nurse Practitioner | 1200 N One Mile Rd, Dexter, MO 63841-1000 | 2015-11-17 |
1841685989 | Angela Weiss | Nurse Practitioner | 1200 N One Mile Rd, Dexter, MO 63841-1000 | 2015-04-06 |
1356762132 | Meramec Emergency Physicians, LLP | Hospitalist | 1200 N One Mile Rd, Dexter, MO 63841-1000 | 2013-12-23 |
1407100944 | Tory L Sherman | Physician Assistant | 1200 N One Mile Rd, Dexter, MO 63841-1000 | 2012-11-06 |
1386802023 | Southeast Health Center of Stoddard County, LLC | Medicare Defined Swing Bed Unit | 1200 N One Mile Rd, Dexter, MO 63841-1000 | 2008-05-29 |
1790828812 | Southeast Health Center of Stoddard County, LLC | Clinic/Center | 1200 N One Mile Rd, Dexter, MO 63841-1000 | 2007-02-15 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1417558941 | Christa Renee Mcbroom | Pharmacist | 2025 Business Hwy 60w, Dexter, MO 63841 | 2020-11-02 |
1306230107 | David Mulcahy | Pharmacist | 904 West Business Hwy 60, Dexter, MO 63841 | 2015-03-19 |
1285038935 | Clearwater In-home Care, Inc. | Technician | 1525 Business Highway 60, Suite C, Dexter, MO 63841 | 2014-10-09 |
1720404064 | William Simmons | Pharmacist | 904 W Business Highway 60, Dexter, MO 63841 | 2014-03-11 |
1134498736 | Susan Caroline Jones | Physical Therapist | 913 West Business Hwy 60, Dexter, MO 63841 | 2011-12-28 |
1427350594 | Dexter Hospital LLC | Family Medicine | 2025 W Bus Hwy 60, Dexter, MO 63841 | 2010-11-23 |
1992028112 | Hilda Fuwell's Residential Care LLC | Clinic/Center | 900 South One Mile Road, Dexter, MO 63841 | 2010-03-02 |
1508197047 | Super D Drugs Acquisition Co | Durable Medical Equipment & Medical Supplies | 907 West Business Hwy. 60, Dexter, MO 63841 | 2010-01-22 |
1215262183 | Ozark Wellness & Athletic Club | Physical Therapist | 1521 W Bus. Hwy. 60, Dexter, MO 63841 | 2009-10-12 |
1225268618 | Practice Tee, LLC | Family Medicine | 1523 W Business Hwy 60, Dexter, MO 63841 | 2009-07-20 |
Find all providers in zip 63841 |
Taxonomy Code | 363LP0200X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Pediatrics |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1467080705 | Jessica Nicole Heichel | Nurse Practitioner | 7729 Brass Creek Ct, Dexter, MI 48130-9384 | 2020-03-31 |
1336404052 | Tonya Mcclain | Nurse Practitioner | 610 N One Mile Rd, Dexter, MO 63841-2539 | 2012-07-09 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1689203390 | Kathleen Rippe Dowd | Nurse Practitioner | 59 Pointer Ln, Saint Louis, MO 63124-2018 | 2020-04-04 |
1871126391 | Kelsey Lonergan | Nurse Practitioner | 10915 Three Court Dr, Saint Louis, MO 63123-5959 | 2020-02-13 |
1518599778 | Eva Maria Gallina | Nurse Practitioner | 4525 Mid Rivers Mall Dr Ste 110, Saint Peters, MO 63376-2820 | 2020-02-06 |
1073150017 | Zoe Marie Wadsworth | Nurse Practitioner | 12255 Depaul Dr Suite 300, Bridgeton, MO 63044 | 2019-12-10 |
1003383324 | Jennifer Marie Jacobi | Nurse Practitioner | 1 Childrens Pl Fl 12, Saint Louis, MO 63110-1002 | 2018-10-24 |
1902315609 | Regina Victoria Maloney | Nurse Practitioner | 851 E 5th St Ste 300, Washington, MO 63090-3130 | 2017-09-25 |
1093235368 | Sally Williams Ehrich | Nurse Practitioner | 1004 Carondelet Dr Ste 350, Kansas City, MO 64114-4801 | 2017-06-27 |
1366995789 | Shawn Danielle Neyens | Nurse Practitioner | 303 N Keene St Ste 404, Columbia, MO 65201-7193 | 2016-08-02 |
1114381563 | Kathleen B Shaughnessy | Nurse Practitioner | 9580 Watson Rd, Ste A, Saint Louis, MO 63126-1539 | 2016-04-12 |
1518327071 | Lauren Sommero | Nurse Practitioner | 1516 Bridge School Road, Rolla, MO 65401-8115 | 2016-02-26 |
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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.