ADVANTAGE PAIN MANAGEMENT INC (NPI# 1770715906) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1770715906 |
Entity Type | Organization |
Organization Name | ADVANTAGE PAIN MANAGEMENT INC |
Practice Address |
11903 Saint Charles Rock Rd Bridgeton MO 63044-2623 |
Practice Telephone | 3147700900 |
Practice Fax Number | 3147701623 |
Mailing Telephone | 3147392900 |
Mailing Fax Number | 3147701623 |
Enumeration Date | 2009-08-21 |
Last Update Date | 2013-02-25 |
Authorized Official Name | DR. H. KENNETH GILBERTSON (OWNER) |
Authorized Official Telephone | 3147392900 |
Authorized Official Credential | D.C. |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 111N00000X | Chiropractor | 003647 | MO | Chiropractic Providers |
N | 247200000X | Technician, Other | Technologists, Technicians & Other Technical Service Providers | ||
N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
N | 363AM0700X |
Physician Assistant Specialization: Medical |
Physician Assistants & Advanced Practice Nursing Providers | ||
Y | 208D00000X | General Practice | Allopathic & Osteopathic Physicians |
Street Address |
11903 SAINT CHARLES ROCK RD |
City | BRIDGETON |
State | MO |
Zip Code | 63044-2623 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1295735926 | Kevin Matthew Wagner | Physical Therapist | 11903 Saint Charles Rock Rd, Bridgeton, MO 63044-2623 | 2005-07-22 |
1114301678 | Md Health and Wellness LLC | Chiropractor | 11903 Saint Charles Rock Rd, Bridgeton, MO 63044-2623 | 2015-07-15 |
1497090567 | Tiffany Mitchell | Technician, Other | 11903 Saint Charles Rock Rd, Bridgeton, MO 63044-2623 | 2012-11-30 |
1548514797 | Tyronda Thomas | Technician, Other | 11903 Saint Charles Rock Rd, Bridgeton, MO 63044-2623 | 2012-11-08 |
1831443084 | Angela Perry | Technician, Other | 11903 Saint Charles Rock Rd, Bridgeton, MO 63044-2623 | 2012-11-08 |
1184772816 | George V Andreoff | Internal Medicine | 11903 Saint Charles Rock Rd, Bridgeton, MO 63044-2623 | 2007-01-08 |
1477659217 | Back Pain Institute of St. Louis, LLC | Chiropractor | 11903 Saint Charles Rock Rd, Bridgeton, MO 63044-2623 | 2006-09-16 |
1902840218 | Flordeliz R Ross | Specialist | 11903 Saint Charles Rock Rd, Bridgeton, MO 63044-2623 | 2006-06-16 |
1871594564 | Arturo J Pamaong | Registered Nurse | 11903 Saint Charles Rock Rd, Back Pain Institute of St. Louis LLC, Bridgeton, MO 63044-2623 | 2005-08-03 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1073150017 | Zoe Marie Wadsworth | Nurse Practitioner | 12255 Depaul Dr Suite 300, Bridgeton, MO 63044 | 2019-12-10 |
1609412451 | Beyond Better, Best Home Health Care Services, Limited Liability Corpo | In Home Supportive Care | 3430 Mckelvey Road Ste B, Bridgeton, MO 63044 | 2019-11-26 |
1275189078 | Delicate Angels Home Health LLC | Home Health | 11726 St. Charles Rock Road Suite G, Bridgeton, MO 63044 | 2019-08-16 |
1588210082 | Nicholas Huber | Physical Therapist | 12349 Depaul Dr., Ste. 110, Bridgeton, MO 63044 | 2019-08-12 |
1124688858 | Michelle Bassett | Registered Nurse | 11520 St. Charles Rock Rd., Suite 106, Bridgeton, MO 63044 | 2019-06-14 |
1336703883 | Elena A Barrow | Nurse Practitioner | 12255 Depaul Dr, Suite 260, Bridgeton, MO 63044 | 2019-04-30 |
1487123105 | Laura N Steiner | Registered Nurse | Gateway Pediatrics, Ltd, 12255 Depaul Drive, Suite 460 North Medical Building, Bridgeton, MO 63044 | 2018-11-26 |
1205310950 | Danielle Mathis | Nurse Practitioner | 3440 Depaul Lane Suite 201, Bridgeton, MO 63044 | 2018-09-19 |
1588163570 | Thoughts Out Loud Counseling, LLC | Social Worker | 11520 St. Charles Rock Road Suite 101, Bridgeton, MO 63044 | 2018-02-06 |
1912411430 | Breanna Victoria Hayes | Counselor | 3165 Mckevley Road, Suite 200, Bridgeton, MO 63044 | 2017-11-20 |
Find all providers in zip 63044 |
Taxonomy Code | 208D00000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | General Practice |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1629077110 | Glenna Carolyn Franke | General Practice | 3394 Mckelvey Rd, Ste 113, Bridgeton, MO 63044-2531 | 2005-07-18 |
1558876912 | George Omondi | General Practice | 11520 Saint Charles Rock Rd, Bridgeton, MO 63044-2704 | 2017-12-07 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1790305654 | Remedy Health LLC | General Practice | 37 Doctors Park Ste 3, Cape Girardeau, MO 63703-4903 | 2020-04-21 |
1760001598 | Md Sarefin Zaman | General Practice | 2715 W 76 Country Blvd Ste 103, Branson, MO 65616-2344 | 2020-04-12 |
1437707551 | Home Docs Medical Associates, LLC | General Practice | 7584 Olive Blvd Ste 204, University City, MO 63130-1600 | 2019-09-02 |
1912462912 | Thomas George Brett | General Practice | 800 Missouri 248, Building 3 Suite A, Branson, MO 65616 | 2019-02-04 |
1295208403 | Sme Kentucky Psc | General Practice | 5728 Pergola Dr Apt 207, Columbia, MO 65201-2897 | 2019-01-10 |
1821579798 | Healthy Schools Missouri LLC | General Practice | 3675 S Noland Rd Ste 200, Independence, MO 64055-3369 | 2018-08-28 |
1902300825 | Landmark Medical of Missouri PC | General Practice | 312 Sw Greenwich Dr # 315, Lees Summit, MO 64082-4408 | 2018-03-23 |
1740784214 | Bridge Integrative Medicine LLC | General Practice | 305 Nw Englewood Ct Ste 200, Kansas City, MO 64118 | 2018-03-20 |
1093218224 | Andrew Jason Doppelt | General Practice | 200 E Southampton Dr Ste 104, Columbia, MO 65203-3032 | 2018-03-14 |
1114427606 | Khrystal Robinson | General Practice | 902 E Reed St, Hayti, MO 63851-1243 | 2018-02-20 |
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.