DR. KURT RUSSELL BRAVATA (NPI# 1790096170) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790096170 |
| Entity Type | Individual |
| Full Name | DR. KURT RUSSELL BRAVATA |
| Credential | M.D. |
| Practice Address |
201 S Ash St Buffalo MO 65622-8674 |
| Mailing Address |
1500 N Oakland Ave Bolivar MO 65613-3011 |
| Practice Telephone | 4173456100 |
| Practice Fax Number | 4173456866 |
| Mailing Telephone | 4173286501 |
| Mailing Fax Number | 4173286338 |
| Enumeration Date | 2010-06-30 |
| Last Update Date | 2016-12-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | 2013030074 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | PALMETTO GBA RAILROAD | P01259379 | 01 |
| Street Address |
201 S ASH ST |
| City | BUFFALO |
| State | MO |
| Zip Code | 65622-8674 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609080571 | Citizens Memorial Healthcare | Clinic/Center | 201 S Ash St, Buffalo, MO 65622-8674 | 2007-05-10 |
| 1316495492 | Gina Nicole Viser | Registered Nurse | 201 S Ash St, Buffalo, MO 65622-8674 | 2016-09-16 |
| 1952726937 | Central Care, Pa | Specialist | 201 S Ash St, Buffalo, MO 65622-8674 | 2014-02-27 |
| 1790032332 | Sara E Hertzke-hill | Physician Assistant | 201 S Ash St, Buffalo, MO 65622 | 2012-08-14 |
| 1306154711 | Ronald David Hunziger | Nurse Practitioner | 201 S Ash St, Buffalo, MO 65622-8674 | 2010-09-20 |
| 1982859195 | Lisa A. Stringfellow | Nurse Practitioner | 201 S Ash St, Buffalo, MO 65622-8674 | 2008-12-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679822217 | Leanne Boggs | Counselor | 1336 S Ash St., Suite 102, Buffalo, MO 65622 | 2012-08-29 |
| 1457589293 | Benson Thomas Pyatt | Dentist | 1006 South Ash, Buffalo, MO 65622 | 2009-07-01 |
| 1124275482 | Premier Residential Care LLC | Assisted Living Facility | 967 North Maple, Buffalo, MO 65622 | 2008-08-19 |
| 1275750879 | Community Clinic of Buffalo LLC | Clinic/Center | 1228 W Truman, Buffalo, MO 65622 | 2007-04-18 |
| 1790887156 | Ed G Pyatt | Dentist | 1006 S Ash, Buffalo, MO 65622 | 2006-09-05 |
| 1497864136 | Christopher L Dugas | Chiropractor | 701 N Maple St, Buffalo, MO 65622 | 2006-08-29 |
| 1598019564 | Ashley Justine Perkins | Physical Therapist | 631 W Main St, Buffalo, MO 65622 | 2012-10-30 |
| 1629103502 | Mercy Clinic-springfield Communities | Family Medicine | 118 W Dallas St, Buffalo, MO 65622 | 2007-02-22 |
| 1386789972 | Dallas County Health Department | Public Health or Welfare | 1011 W Main, Buffalo, MO 65622-0199 | 2007-02-21 |
| 1912276809 | Buffalo Prairie Dental | Dentist | 1006 S. Ash, Buffalo, MO 65622-0707 | 2011-12-21 |
| Find all providers in zip 65622 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710309414 | Chs N.y. Medical P.C. | General Practice | 10 Sheridan Rd, Buffalo, NY 14201 | 2014-01-15 |
| 1144461849 | Michele Lea Bassler | General Practice | 126 W Humboldt Pkwy, Buffalo, NY 14214-2607 | 2009-03-10 |
| 1871592931 | Robin B. Hall | General Practice | 1003 Highway 64 North, Buffalo, OK 73834 | 2005-07-20 |
| 1316443096 | Connect Medical, P.C. | General Practice | 701 Seneca St Ste 646c, Buffalo, NY 14210 | 2018-04-02 |
| 1144620980 | Landmark Health Ny Ipa | General Practice | 701 Seneca St, Suite 416, Buffalo, NY 14210-1351 | 2014-08-29 |
| 1962801860 | Landmark Medical PC | General Practice | 701 Seneca St Ste 646c, Buffalo, NY 14210-1351 | 2014-08-15 |
| 1780691840 | Linda Lazarus Benjamin | General Practice | 50 Lakefront Blvd, Buffalo, NY 14202-4327 | 2006-08-02 |
| 1588688964 | Bidappa G. Maneyapanda | General Practice | 173 High St, Buffalo, NY 14204-1152 | 2006-07-27 |
| 1003894122 | Johnson County Memorial Hospital | General Practice | 497 West Lott, Buffalo, WY 82834-1609 | 2006-01-09 |
| 1700885894 | Neal Kent Suthers | General Practice | 1001 Hwy 64 N, Buffalo, OK 73834-0010 | 2005-07-20 |
| Find all providers in BUFFALO | ||||
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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.