MATT E THORNBURG (NPI# 1447244330) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447244330 |
| Entity Type | Individual |
| Full Name | MATT E THORNBURG |
| Credential | M.D. |
| Practice Address |
1 S Keene St Columbia MO 65201-7199 |
| Practice Telephone | 5734432402 |
| Practice Fax Number | 5734430574 |
| Mailing Telephone | 5734432402 |
| Mailing Fax Number | 5734430574 |
| Enumeration Date | 2005-09-07 |
| Last Update Date | 2011-11-04 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QS0010X |
Family Medicine Specialization: Sports Medicine |
2000161380 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 203746714 | 05 |
| Street Address |
1 S KEENE ST |
| City | COLUMBIA |
| State | MO |
| Zip Code | 65201-7199 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689673592 | David H Neighbors | Physician Assistant | 1 S Keene St, Columbia, MO 65201-7199 | 2005-07-21 |
| 1801414800 | Brianne Ketterlin | Registered Nurse | 1 S Keene St, Columbia, MO 65201-7199 | 2020-07-07 |
| 1831721141 | Alyssa Fancher | Pharmacist | 1 S Keene St, Columbia, MO 65201-7199 | 2020-02-05 |
| 1932673670 | Lauren Elizabeth Monesmith | Physician Assistant | 1 S Keene St, Columbia, MO 65201-7199 | 2019-01-16 |
| 1407360217 | Greg Allen Nagel | Specialist/Technologist | 1 S Keene St, Columbia, MO 65201-7199 | 2017-12-01 |
| 1821510389 | Ashley Rose Burr | Nurse Practitioner | 1 S Keene St, Columbia, MO 65201-7199 | 2017-07-16 |
| 1801321161 | Amy Dentlinger | Physician Assistant | 1 S Keene St, Columbia, MO 65201 | 2017-04-25 |
| 1245775295 | Michael Bozung | Nurse Anesthetist, Certified Registered | 1 S Keene St, Columbia, MO 65201-7199 | 2016-12-29 |
| 1083164370 | Alaina R Durk | Nurse Practitioner | 1 S Keene St, Columbia, MO 65201-7199 | 2016-10-11 |
| 1104375864 | Jennifer Miller | Nurse Practitioner | 1 S Keene St, Columbia, MO 65201-7199 | 2016-09-22 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134688534 | Thomas Havey | Specialist/Technologist | 600 E Stadium Boulevard, Columbia, MO 65201 | 2019-03-15 |
| 1881176121 | Darrea L Green | Nurse Practitioner | 3700 Interstate 70 Dr Se, Columbia, MO 65201 | 2018-09-04 |
| 1073092383 | Andrea L. Lingenfelter | Registered Nurse | 1605 East Broadway, Ste. 100, Columbia, MO 65201 | 2018-08-08 |
| 1144724238 | Angela Marie Richmond | Internal Medicine | 1 Hospital Dr Rm Ma423, Columbia, MO 65201 | 2018-03-22 |
| 1770092892 | Palmer's Home Care, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 701 Hillsdale Road, Columbia, MO 65201 | 2017-09-20 |
| 1205358710 | Mitchell E Swee | Specialist/Technologist | 600 East Stadium Blvd, Columbia, MO 65201 | 2017-07-17 |
| 1659815470 | Colleen Jockin | Specialist | 100 Matc, Columbia, MO 65201 | 2016-12-13 |
| 1720535305 | Hannah Garrad | Dietitian, Registered | Columbia 3, 25 Conley Road, Columbia, MO 65201 | 2016-09-01 |
| 1043662570 | Restoration Chiropractic LLC | Chiropractor | 1413 Grindstone Plaza Drive, Columbia, MO 65201 | 2016-07-08 |
| 1306298930 | Taylor John Sirois | Chiropractor | 1413 Grindstone Plaza Dr., Columbia, MO 65201 | 2016-07-07 |
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| Taxonomy Code | 207QS0010X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Sports Medicine |
| A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Family Medicine, 2007. http://www.theabfm.org/. American Osteopathic Board of Family Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689960171 | Nathan Lee Granneman | Family Medicine | 200 Corporate Lake Dr, Columbia, MO 65203-7172 | 2011-06-22 |
| 1376742411 | Jeffrey P Holloway | Family Medicine | 9 Medical Park, Suite 200-a, Columbia, SC 29203-6878 | 2007-07-17 |
| 1508876434 | Andrew Thomas Mcgown | Family Medicine | 2 Medical Park Rd Ste 104, Columbia, SC 29203-6839 | 2006-08-09 |
| 1013951250 | Christopher D. Farmer | Family Medicine | 1 S Keene St, Columbia, MO 65201-7199 | 2006-06-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871105312 | 417 Sports Medicine and Orthopedics LLC | Family Medicine | 330 W Plainview Rd Ste F, Springfield, MO 65810-2672 | 2020-08-17 |
| 1871115857 | Ben Heimos | Family Medicine | 1 S Compton Ave, Saint Louis, MO 63103-2001 | 2020-05-12 |
| 1639645070 | Bluetail Biologics LLC | Family Medicine | 17300 N Outer 40 Rd Ste 201, Chesterfield, MO 63005-1364 | 2018-10-23 |
| 1083096671 | Daniel O'loughlin | Family Medicine | 1605 Martin Springs Dr Ste 330, Rolla, MO 65401-2980 | 2015-06-19 |
| 1295175057 | Devin Willis | Family Medicine | 16555 Manchester Rd Ste 100, Wildwood, MO 63040 | 2013-06-26 |
| 1922377274 | Duocorp Enterprises, LLC | Family Medicine | 1525 E Republic Rd, Suite A115, Springfield, MO 65804-6527 | 2011-12-15 |
| 1063568640 | Christian Verry | Family Medicine | 12680 Olive Blvd Ste 300, Saint Louis, MO 63141-6322 | 2007-01-26 |
| 1922116763 | Kristin Suzanne Oliver | Family Medicine | 17300 North Outer 40 Rd Ste 201, Chesterfield, MO 63005-1364 | 2006-08-29 |
| 1942238027 | John J Dougherty | Family Medicine | 1010 Carondelet Dr Ste 220, Kansas City, MO 64114-4822 | 2006-06-29 |
| 1548867963 | Elizabeth Savika Liotta | Family Medicine | 916 Olive St, Saint Louis, MO 63101-1400 | 2020-10-08 |
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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.