TODD PHILLIP DECARLIS (NPI# 1598004152) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598004152 |
| Entity Type | Individual |
| Full Name | TODD PHILLIP DECARLIS |
| Credential | PA |
| Practice Address |
2900 S National Ave Springfield MO 65804-3634 |
| Mailing Address |
Po Box 4024 Springfield MO 65808-4024 |
| Practice Telephone | 4178853888 |
| Practice Fax Number | 4178817638 |
| Mailing Telephone | 4178853888 |
| Mailing Fax Number | 4178817638 |
| Enumeration Date | 2013-02-01 |
| Last Update Date | 2013-02-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
2013003532 | MO | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
2900 S NATIONAL AVE |
| City | SPRINGFIELD |
| State | MO |
| Zip Code | 65804-3634 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932192895 | Jennifer Marie Probstfield | Specialist/Technologist | 2900 S National Ave, Springfield, MO 65804-3634 | 2005-08-25 |
| 1407376619 | Lauren Branham | Family Medicine | 2900 S National Ave, Springfield, MO 65804-3634 | 2017-06-20 |
| 1174067631 | Lester E Cox Medical Centers | Family Medicine | 2900 S National Ave, Springfield, MO 65804-3634 | 2016-12-16 |
| 1639529597 | Whitney Davis | Family Medicine | 2900 S National Ave, Springfield, MO 65804-3634 | 2016-06-21 |
| 1245680107 | James Ganus | Family Medicine | 2900 S National Ave, Springfield, MO 65804-3634 | 2016-06-21 |
| 1467828202 | Ibrahim Abdelhamid Alahmad | Nurse Practitioner | 2900 S National Ave, Springfield, MO 65804-3634 | 2015-08-17 |
| 1437565223 | Marlana Marie Bray | Family Medicine | 2900 S National Ave, Springfield, MO 65804-3634 | 2014-07-01 |
| 1871892083 | Alyse Megan Fields | Dietitian, Registered | 2900 S National Ave, Springfield, MO 65804-3634 | 2011-03-28 |
| 1992018287 | Jennifer Snyder | Family Medicine | 2900 S National Ave, Springfield, MO 65804-3634 | 2010-07-15 |
| 1902119290 | Stephanie E. Pendergrass | Family Medicine | 2900 S National Ave, Springfield, MO 65804-3634 | 2010-07-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790393049 | Kathy Forson | Nurse Practitioner | 1235 E. Cherokee St., Springfield, MO 65804 | 2020-07-22 |
| 1306498779 | Anne B Summers, LLC | Social Worker | 1310 E. Kingsley St., Ste C, Springfield, MO 65804 | 2019-07-15 |
| 1790241800 | Margaret Mary Hart | Social Worker | 1845 S Rogers Ave, Springfield, MO 65804 | 2019-02-13 |
| 1598254666 | Casey Carr | Optometrist | 1229 E Seminole St Ste 110, Springfield, MO 65804 | 2018-05-04 |
| 1124520697 | Shelby D White | Behavioral Analyst | 1300 E. Bradford Parkway, Springfield, MO 65804 | 2018-03-01 |
| 1316448343 | Karl Lynham | Massage Therapist | 1200 E Woodhurst Dr R300, Springfield, MO 65804 | 2018-02-25 |
| 1699273763 | Leah Wilson | Counselor | 1322 E Woodgate, Springfield, MO 65804 | 2018-01-24 |
| 1295242626 | Matthew Crisp | Physical Therapist | 3252 E Independence St, Springfield, MO 65804 | 2018-01-08 |
| 1518491042 | Crystal Spangler | Dietitian, Registered | 1965 S Fremont Ave Ste 220, Springfield, MO 65804 | 2017-04-11 |
| 1588012033 | Jeffrey Williams | Pharmacist | 1235 E. Cherokee, Springfield, MO 65804 | 2016-05-25 |
| Find all providers in zip 65804 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629592225 | Justin William Starling | Physician Assistant | 1515 Keys Ave, Springfield, IL 62702-2933 | 2017-07-26 |
| 1710435011 | Alexander Andersen | Physician Assistant | 445 Harlow Rd Ste 200, Springfield, OR 97477-1341 | 2016-09-14 |
| 1932538980 | Emily Baecher | Physician Assistant | 2 Medical Cetner Dr, Suite 205, Springfield, MA 01199-1619 | 2013-11-09 |
| 1699114421 | Lauren M Kendall | Physician Assistant | 960 N 16th St Ste 108, Springfield, OR 97477-4175 | 2013-06-14 |
| 1750660148 | Daniel Francis Reilly Jr. | Physician Assistant | 2 Medical Center Dr Ste 308, Springfield, MA 01107-1271 | 2011-08-16 |
| 1831499383 | Christin Wolak | Physician Assistant | 300 Birnie Ave Ste 201, Springfield, MA 01107-1121 | 2010-11-01 |
| 1811200710 | Jessica Anne White | Physician Assistant | 25 Ridgewood Rd., Esne, Springfield, VT 05156 | 2010-07-20 |
| 1043540669 | Kristen Dawn Dodd | Physician Assistant | 960 N 16th St Ste 207, Springfield, OR 97477-4175 | 2010-01-04 |
| 1831337765 | Cynthia R. Krinochkin | Physician Assistant | 3801 S. National, 5th Floor, Springfield, MO 65807-5210 | 2009-01-30 |
| 1578746079 | Jamie Moore | Physician Assistant | 2 Medical Center Drive Suite 503, Springfield, MA 01199-0001 | 2007-12-07 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 65804 |
Please comment or provide details below to improve the information on TODD PHILLIP DECARLIS.
| 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.