DR. BERNARD A GRIESEMER (NPI# 1750421640) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750421640 |
| Entity Type | Individual |
| Full Name | DR. BERNARD A GRIESEMER |
| Credential | MD |
| Practice Address |
4331 S Fremont Ave Springfield MO 65804-7328 |
| Mailing Address |
Po Box 2580 Springfield MO 65801-2580 |
| Practice Telephone | 4178205000 |
| Practice Fax Number | 4178205025 |
| Mailing Telephone | 4178294620 |
| Enumeration Date | 2007-02-08 |
| Last Update Date | 2013-05-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | R6866 | MO | Allopathic & Osteopathic Physicians |
| Y | 208000000X | Pediatrics | R6866 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | MO BLUE SHIELD | 13118 | 01 |
| AR | ARK BLUE SHIELD | 82172 | 01 |
| MO | 200254837 | 05 |
| Street Address |
4331 S FREMONT AVE |
| City | SPRINGFIELD |
| State | MO |
| Zip Code | 65804-7328 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144201369 | Mitchell Dean Hauschildt | Specialist/Technologist | 4331 S Fremont Ave, Healthtracks Sports Training Center, Springfield, MO 65804-7328 | 2005-11-07 |
| 1568094175 | Katie Primrose | Specialist/Technologist | 4331 S Fremont Ave, Springfield, MO 65804-7328 | 2020-02-11 |
| 1962042358 | Michael James Lane | Specialist/Technologist | 4331 S Fremont Ave, Springfield, MO 65804-7328 | 2020-01-13 |
| 1578038550 | Kelsey Kapella | Specialist/Technologist | 4331 S Fremont Ave, Springfield, MO 65804-7328 | 2018-10-05 |
| 1487134722 | Connor Parrish | Physical Medicine & Rehabilitation | 4331 S Fremont Ave, Springfield, MO 65804-7328 | 2018-08-16 |
| 1730669060 | Jessica M Jones | Specialist/Technologist | 4331 S Fremont Ave, Springfield, MO 65804-7328 | 2018-08-16 |
| 1619457207 | Derek Allen Clayton | Specialist/Technologist | 4331 S Fremont Ave, Springfield, MO 65804-7328 | 2018-08-14 |
| 1285153650 | Holly Nicole Ode | Nurse Practitioner | 4331 S Fremont Ave, Springfield, MO 65804-7328 | 2017-09-16 |
| 1134640246 | Alexandra Jahnke | Specialist/Technologist | 4331 S Fremont Ave, Springfield, MO 65804-7328 | 2017-06-28 |
| 1972041358 | Ryinne A Jacquemin | Student in an Organized Health Care Education/Training Program | 4331 S Fremont Ave, Springfield, MO 65804-7328 | 2017-02-06 |
| 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 | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467074492 | Kinnera Are | Pediatrics | 400 N 9th St Ste 4a, Springfield, IL 62702-5310 | 2020-05-13 |
| 1306208368 | Mckenzie Smith | Pediatrics | 2115 S Fremont Ave Ste 2900, Springfield, MO 65804-2233 | 2016-03-28 |
| 1790181402 | Sonam Verma | Pediatrics | 400 N 9th St # 4a, Springfield, IL 62702-5310 | 2014-11-06 |
| 1619382132 | Eric D Mcfeely | Pediatrics | 280 Chestnut Street, 2nd Floor, Springfield, MA 01199-1001 | 2014-06-23 |
| 1073923231 | Charlotte Mcknight | Pediatrics | 6120 Brandon Ave Ste 308, Springfield, VA 22150-2504 | 2014-04-28 |
| 1336437078 | Rashmi Jain | Pediatrics | 1965 S Fremont Ave Ste 260, Springfield, MO 65804-2257 | 2011-07-15 |
| 1861785958 | Sienna Vorono Winer | Pediatrics | 6501 Loisdale Ct., Springfield, VA 22150 | 2011-05-23 |
| 1649581570 | Kendra Suzanne Woods | Pediatrics | 415 N 9th St Ste 2w126, Springfield, IL 62702-5303 | 2010-06-25 |
| 1518117159 | Jyoti Assudani | Pediatrics | 301 N 8th Street, Springfield, IL 62701 | 2008-09-19 |
| 1417105024 | Stephen Edward Saunders | Pediatrics | 5 Orchard Ln, Springfield, IL 62712-8911 | 2008-09-08 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 65804 |
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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.