PRIMARY CARE DE SOTO, LLC (NPI# 1497392732) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497392732 |
| Entity Type | Organization |
| Organization Name | PRIMARY CARE DE SOTO, LLC |
| Practice Address |
420 N Main St De Soto MO 63020-1538 |
| Practice Telephone | 3143981533 |
| Enumeration Date | 2019-12-05 |
| Last Update Date | 2019-12-05 |
| Authorized Official Name | TIMOTHY MAXVILL (PARTNER) |
| Authorized Official Telephone | 3143981533 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities |
| Street Address |
420 N MAIN ST |
| City | DE SOTO |
| State | MO |
| Zip Code | 63020-1538 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700435385 | Patsy Maness | Technician | 5100 Knorpp Road, De Soto, MO 63020 | 2019-09-06 |
| 1013268911 | Jane Susann Brenneke | Counselor | 116 B 2nd Street, Desoto, MO 63020 | 2012-10-02 |
| 1477634277 | Wal-mart Stores East, Lp | Technician/Technologist | 12862 State Road 21, De Soto, MO 63020 | 2006-10-18 |
| 1235109877 | John W Dickinson | Dentist | 704 N Main Street, Desoto, MO 63020 | 2006-01-25 |
| 1700883253 | Valle Ambulance District | Ambulance | 12363 State Route 21, De Soto, MO 63020 | 2005-06-30 |
| 1568893105 | Terence A. Friskel | Dentist | 110 North Main, Desoto, MO 63020 | 2013-12-09 |
| 1457541427 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 12977 State Route 21, De Soto, MO 63020-1000 | 2007-07-26 |
| 1982880084 | Thomas L. Monje, O.d. | Optometrist | 26 Jefferson Sq, De Soto, MO 63020-1031 | 2008-01-18 |
| 1548266737 | Steven Crawford | Family Medicine | 12 Jefferson Sq, De Soto, MO 63020-1031 | 2005-06-22 |
| 1720595200 | Danielle Marie Howerton | Nurse Practitioner | 12 Jefferson Sq, De Soto, MO 63020-1031 | 2018-01-05 |
| Find all providers in zip 63020 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
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| 1174145668 | Essential Benefit Offerings, LLC | Clinic/Center | 1417 N Mount Auburn Rd Ste A2, Cape Girardeau, MO 63701-2171 | 2020-05-07 |
| 1114483468 | Your Optimal Healthcare LLC | Clinic/Center | 300 W 4th St Ste H, Eureka, MO 63025-1839 | 2019-02-12 |
| 1306313051 | Country Care Family Clinic, LLC | Clinic/Center | 3 E Cleveland Ave, Ellsinore, MO 63937 | 2018-10-31 |
| 1285118950 | Vera Whole Health, Wa PC | Clinic/Center | 8350 N. Church Road, Kansas City, MO 64158 | 2018-09-19 |
| 1003324542 | Quad/med, LLC | Clinic/Center | 2015 Ne Jefferson Street, Grain Valley, MO 64029 | 2018-01-18 |
| 1093267601 | Careatc-saint Peter | Clinic/Center | 4601 Executive Centre Pkwy, Saint Peters, MO 63376-1683 | 2016-10-30 |
| 1407303480 | Kerns Family Health Care LLC | Clinic/Center | 1335 Vilage Dr B, St. Joseph, MO 64506-2457 | 2016-09-07 |
| 1316491020 | Wecare Tlc - Wwt Mo Family Health Center | Clinic/Center | 58 Weldon Pkwy, Bldg 58, Maryland Heights, MO 63043-3237 | 2016-08-10 |
| 1255703500 | Community Hospital Association | Clinic/Center | 101 South Washington Street, Oregon, MO 64473 | 2015-10-27 |
| 1023485752 | Dennis E. Robinson D.o. | Clinic/Center | 487 Pomme De Terre Dr., Marshfield, MO 65706 | 2015-08-28 |
| 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.