JEFFREY STEVEN BOBERG (NPI# 1437264595) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437264595 |
| Entity Type | Individual |
| Full Name | JEFFREY STEVEN BOBERG |
| Credential | D.P.M. |
| Practice Address |
9323 Phoenix Village Pkwy O Fallon MO 63368-4281 |
| Practice Telephone | 6365610871 |
| Practice Fax Number | 6365615032 |
| Mailing Telephone | 6365610871 |
| Mailing Fax Number | 6365615032 |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2019-07-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 213E00000X | Podiatrist | 000570 | MO | Podiatric Medicine & Surgery Service Providers |
| Y | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
000570 | MO | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | DMERC | 5031350001 | 01 |
| MO | 302436829 | 05 | |
| MO | RAILROAD MEDICARE | P00081678 | 01 |
| IL | DMERC | 5031350002 | 01 |
| Street Address |
9323 PHOENIX VILLAGE PKWY |
| City | O FALLON |
| State | MO |
| Zip Code | 63368-4281 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205839354 | Emil A Difilippo | Orthopaedic Surgery | 9323 Phoenix Village Pkwy, O Fallon, MO 63366-4281 | 2005-05-23 |
| 1073904769 | Signature Medical Group, Inc | Durable Medical Equipment & Medical Supplies | 9323 Phoenix Village Pkwy, O Fallon, MO 63368-4281 | 2015-02-17 |
| 1447454103 | Kevin James Quigley | Orthopaedic Surgery | 9323 Phoenix Village Pkwy, O Fallon, MO 63368-4281 | 2007-06-14 |
| 1174561211 | Matthew Paul Melander | Orthopaedic Surgery | 9323 Phoenix Village Pkwy, O Fallon, MO 63368-4281 | 2006-06-02 |
| 1275536120 | James E Schaberg | Orthopaedic Surgery | 9323 Phoenix Village Pkwy, O Fallon, MO 63366-4281 | 2005-05-24 |
| 1710980750 | Mark K Keohane | Orthopaedic Surgery | 9323 Phoenix Village Pkwy, O Fallon, MO 63366-4281 | 2005-05-23 |
| 1710980875 | Anthony J Berni | Orthopaedic Surgery | 9323 Phoenix Village Pkwy, O Fallon, MO 63366-4281 | 2005-05-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134720329 | Come As You Are Counseling LLC | Counselor | 1001 Boardwalk Springs Place, Suite 111, O Fallon, MO 63368 | 2020-11-04 |
| 1770124802 | Lisa N. Greer | Technician | 6911 Brassel Dr., Ofallon, MO 63368 | 2019-09-30 |
| 1770145716 | Halie Faye Gulley | Dentist | 3009 Hwy K, O'fallon, MO 63368 | 2019-06-29 |
| 1972079556 | Erin Corsi Fraundorf | Dentist | 3009 State Hwy K, O'fallon, MO 63368 | 2018-10-22 |
| 1427579960 | Air Evac Ems, Inc. | Ambulance | 1001 Boardwalk Springs Pl Ste 250, O Fallon, MO 63368 | 2017-07-06 |
| 1528507472 | Washeck Manual Therapy LLC | Clinic/Center | 3074 Winghaven Blvd, O'fallon, MO 63368 | 2017-02-13 |
| 1639618457 | Brittany Hogan | Physical Therapist | 7412 South Outer 364, Suite B, Dardenne Prairie, MO 63368 | 2017-02-13 |
| 1124561469 | Cardinal Home Care LLC | Home Health | 18 Convent Garden Ct, O'fallon, MO 63368 | 2016-11-18 |
| 1336509272 | Sarah Marie Mudd | Counselor | 1654 Bryan Road, O'fallon, MO 63368 | 2016-03-04 |
| 1588023956 | Price-bourisaw Family Chiropractic | Chiropractor | 2917 State Highway K, O Fallon, MO 63368 | 2016-02-15 |
| Find all providers in zip 63368 | ||||
| Taxonomy Code | 213ES0103X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Foot & Ankle Surgery |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386263895 | C James Anderson Dpm LLC | Podiatrist | 717 Insight Ave Ste 100, O Fallon, IL 62269-2193 | 2020-04-14 |
| 1881031730 | Daniel Joseph Thouvenot | Podiatrist | 784 Wall St Ste C, O Fallon, IL 62269-2088 | 2013-06-02 |
| 1124165428 | Julie Elizabeth Stewart | Podiatrist | 300 Winding Woods Dr, Suite214, O Fallon, MO 63366-4771 | 2007-01-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851923023 | Center for Advanced Foot & Ankle Surgery, Inc. | Podiatrist | 3915 Watson Rd Ste 200, Saint Louis, MO 63109-1251 | 2020-02-06 |
| 1518486885 | Sunflower Podiatry and Wellness | Podiatrist | 1316 Hebert Street, Saint Louis, MO 63107 | 2017-09-18 |
| 1144753492 | Creighton Woolsey | Podiatrist | 1155 W Parkview St Ste 2j, Bolivar, MO 65613-8598 | 2017-04-04 |
| 1457701559 | Robert Austin Djali | Podiatrist | 1224 Graham Rd Ste 3010, Florissant, MO 63031-8028 | 2016-06-20 |
| 1770978074 | Shelly Diane Sedberry | Podiatrist | 1801 W 32nd St Bldg C, Joplin, MO 64804 | 2015-04-02 |
| 1376936591 | Corey Bess | Podiatrist | 1010 Carondelet Dr Ste 301, Kansas City, MO 64114 | 2015-03-12 |
| 1093117335 | True Health Integration and Synergy | Podiatrist | 6311 Ronald Reagan Dr, #167, Lake St Louis, MO 63367-2681 | 2014-09-18 |
| 1710305677 | Kevin M Renner | Podiatrist | 225 Physicians Park Ste 102, Poplar Bluff, MO 63901-3918 | 2014-03-28 |
| 1134474554 | Rajan K Patel | Podiatrist | 3930 S Jackson Dr, Apt 308, Independence, MO 64057-1706 | 2012-07-23 |
| 1720346307 | Feet for Life Centers Inc PC | Podiatrist | 17201 Chesterfield Airport Rd, Chesterfield, MO 63005-1423 | 2012-05-02 |
| Find all providers with the same taxonomy | ||||
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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.