DR. NORMAN DOUGLAS CRECELIUS (NPI# 1659332179) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659332179 |
| Entity Type | Individual |
| Full Name | DR. NORMAN DOUGLAS CRECELIUS |
| Credential | DO |
| Practice Address |
1101 W Liberty St Farmington MO 63640-1921 |
| Mailing Address |
702 Ozark Dr Farmington MO 63640-2128 |
| Practice Telephone | 5737566451 |
| Mailing Telephone | 5737566015 |
| Mailing Fax Number | 5737569682 |
| Enumeration Date | 2006-04-01 |
| Last Update Date | 2008-04-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207PE0004X |
Emergency Medicine Specialization: Emergency Medical Services |
R602 | MO | Allopathic & Osteopathic Physicians |
| Street Address |
1101 W LIBERTY ST |
| City | FARMINGTON |
| State | MO |
| Zip Code | 63640-1921 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912970880 | Vladimir Melyakov | Internal Medicine | 1101 W Liberty St, Farmington, MO 63640-1921 | 2006-02-09 |
| 1891303053 | Parkland Health Center | Clinical Medical Laboratory | 1101 W Liberty St, Farmington, MO 63640-1921 | 2020-07-14 |
| 1902430481 | Nrg-parkland LLC | Radiology | 1101 W Liberty St, Farmington, MO 63640-1921 | 2020-02-24 |
| 1700342847 | Alyssa Michelle Bocci | Physician Assistant | 1101 W Liberty St, Farmington, MO 63640-1921 | 2019-02-13 |
| 1811414626 | Nawaf Al-hashemi | Internal Medicine | 1101 W Liberty St, Farmington, MO 63640-1921 | 2017-08-23 |
| 1063959104 | Southern Missouri Infectious Disease Specialists LLC | Internal Medicine | 1101 W Liberty St, Farmington, MO 63640 | 2017-01-27 |
| 1265981856 | Matthew Akers | Nurse Practitioner | 1101 W Liberty St, Farmington, MO 63640-1921 | 2016-09-24 |
| 1780037630 | Meredith Politte | Nurse Practitioner | 1101 W Liberty St, Farmington, MO 63640-1921 | 2016-07-15 |
| 1801252812 | Alyssa Trautman | Dietitian, Registered | 1101 W Liberty St, Farmington, MO 63640-1921 | 2016-01-06 |
| 1770957201 | Mid-america Clinical Pathology, LLC | Pathology | 1101 W Liberty St, Farmington, MO 63640-1921 | 2015-11-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316545254 | Brenda S Halton | Nurse Practitioner | 1010 West Columbia Street, Farmington, MO 63640 | 2020-10-13 |
| 1619519089 | Stacey Nicole Gillette | Counselor | 17885 Hart Pinkston Rd, Farmington, MO 63640 | 2019-10-17 |
| 1346890696 | Christopher Ryan Massey | Social Worker | 607 Pine St., Farmington, MO 63640 | 2019-09-18 |
| 1457909376 | Clarice Ogden | Social Worker | 203 South Washington Street, Farmington, MO 63640 | 2019-09-04 |
| 1861979718 | Clint Thebeau | In Home Supportive Care | 1276 W Liberty St, Farmington, MO 63640 | 2018-07-24 |
| 1023500600 | Lynn Machelle Knox | Counselor | 219 W Columbia St, Farmington, MO 63640 | 2018-05-31 |
| 1235620576 | Kim Bazzell | Registered Nurse | 1565 Ste. Genevieve Ave., Farmington, MO 63640 | 2018-05-22 |
| 1164919742 | Lincare Inc. | Durable Medical Equipment & Medical Supplies | 774 Market St, Farmington, MO 63640 | 2018-04-18 |
| 1184127813 | Michelle Lynette Corvallis | Chiropractor | 17 South Franklin St., Farmington, MO 63640 | 2018-03-08 |
| 1992206213 | Farmington Vision Care LLC | Optometrist | 110 E Harrison St, Farmington, MO 63640 | 2018-02-22 |
| Find all providers in zip 63640 | ||||
| Taxonomy Code | 207PE0004X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| Specialization | Emergency Medical Services |
| An emergency medicine physician who specializes in non-hospital based emergency medical services (e.g., disaster site, accident scene, transport vehicle, etc.) to provide pre-hospital assessment, treatment, and transport patients. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) is issued by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518249929 | Doc Network, Inc. | Emergency Medicine | 11705 E Creek Ln, Farmington, AR 72730-9564 | 2011-09-12 |
| 1104903582 | Michael Lamb | Emergency Medicine | 1212 Weber Rd, Farmington, MO 63640-3325 | 2006-11-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962777557 | Blue Springs Emergency Physician Services PC | Emergency Medicine | 201 Nw Rd Mize Road, Blue Springs, MO 64014 | 2012-03-14 |
| 1225160179 | William F Bowman | Emergency Medicine | Heartland Regional Medical Center, 5325 Faraon St, St. Joseph, MO 64506 | 2007-03-09 |
| 1750434999 | Luis Robles | Emergency Medicine | 529 Southwest Blvd, Kansas City, MO 64108-2122 | 2007-01-19 |
| 1134215759 | Guy R Kline | Emergency Medicine | 6141 Oak Creek Dr, Osage Beach, MO 65065-2571 | 2006-10-04 |
| 1053413542 | Michael Eligio Fritsche | Emergency Medicine | 625 Bemis Heights Pl, Saint Charles, MO 63303-1752 | 2006-09-04 |
| 1144251679 | Akeeb Adedokun | Emergency Medicine | 5058 Romaine Spring Dr, Fenton, MO 63026-5868 | 2006-07-05 |
| 1598700684 | Raana J Ponstingl | Emergency Medicine | 3635 Vista At Grand Boulevard, Saint Louis, MO 63110 | 2006-06-20 |
| 1740264670 | Pamela Westerling | Emergency Medicine | 230 Tompkins Court, Troy, MO 63379 | 2005-12-05 |
| 1104432640 | Complex Healthcare of Des Peres LLC | Emergency Medicine | 1032 Old Des Peres Rd, Saint Louis, MO 63131-1865 | 2020-09-21 |
| 1003337858 | William Kells Boland | Emergency Medicine | 1 Barnes-jewish Hospital Plaza, St. Louis, MO 63110 | 2017-07-02 |
| Find all providers with the same taxonomy | ||||
| City | FARMINGTON |
| Zip Code | 63640 |
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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.