BREANNA R. BURKS (NPI# 1790102366) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790102366 |
| Entity Type | Individual |
| Full Name | BREANNA R. BURKS |
| Credential | PA-C |
| Practice Address |
2115 S Fremont Ave Ste 4300 Springfield MO 65804-2239 |
| Mailing Address |
Po Box 505164 Saint Louis MO 63150-5164 |
| Practice Telephone | 4178203911 |
| Practice Fax Number | 4178203924 |
| Mailing Telephone | 4178294620 |
| Mailing Fax Number | 4178294316 |
| Enumeration Date | 2014-03-21 |
| Last Update Date | 2014-12-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 2014008687 | MO | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
2115 S FREMONT AVE STE 4300 |
| City | SPRINGFIELD |
| State | MO |
| Zip Code | 65804-2239 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750383543 | Steven K Bowlin | Internal Medicine | 2115 S Fremont Ave, Ste 2300, Springfield, MO 65804-2239 | 2005-08-11 |
| 1932656535 | Jill Cotner | Registered Nurse | 2115 S Fremont Ave, Ste 3300, Springfield, MO 65804-2239 | 2016-09-01 |
| 1427437185 | Ashleigh D. Gentles | Nurse Practitioner | 2115 S Fremont Ave, Springfield, MO 65804-2239 | 2015-05-27 |
| 1063805489 | Chad D. Holland | Physician Assistant | 2115 S Fremont Ave, Suite 5000, Springfield, MO 65804-2239 | 2015-03-10 |
| 1609267731 | Chrystal M. Killinger | Nurse Practitioner | 2115 S Fremont Ave, Suite 3300, Springfield, MO 65804-2239 | 2015-02-11 |
| 1497145767 | Joshua Steven Reece | Physician Assistant | 2115 S Fremont Ave, Ste 5000, Springfield, MO 65804-2239 | 2015-01-26 |
| 1154724144 | Melissa Diane Grisaffe | Nurse Practitioner | 2115 S Fremont Ave, Springfield, MO 65804-2239 | 2014-10-03 |
| 1154745537 | Tarrah Divine | Nurse Practitioner | 2115 S Fremont Ave, Ste 4300, Springfield, MO 65804-2239 | 2014-02-06 |
| 1831539428 | Lacy A. Schnelle | Registered Nurse | 2115 S Fremont Ave, Suite 4300, Springfield, MO 65804-2239 | 2013-06-27 |
| 1881936797 | Tabatha Renee Luneau | Physician Assistant | 2115 S Fremont Ave, Suite 5000, Springfield, MO 65804-2239 | 2013-03-19 |
| 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 | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972123289 | Jared Anthony Dias | Physician Assistant | 52 Devens St, Springfield, MA 01151-2304 | 2020-04-16 |
| 1659990976 | Maham Siddiqui | Physician Assistant | 8632 Hillside Manor Dr, Springfield, VA 22152-2238 | 2020-04-16 |
| 1558994772 | Kayla Rice | Physician Assistant | 3640 Main St Ste 103, Springfield, MA 01107-1139 | 2020-02-17 |
| 1487286563 | Michayla Marcil | Physician Assistant | 280 Chestnut St Fl 2, Springfield, MA 01199-1001 | 2020-02-06 |
| 1508416140 | Chase Michael Collings | Physician Assistant | 960 N 16th St Ste 303, Springfield, OR 97477 | 2019-09-16 |
| 1023670593 | Michael Peter Lembotesis | Physician Assistant | 629 Evans Rd, Springfield, PA 19064-3033 | 2019-07-03 |
| 1245795558 | Alexandra Marie Cutler | Physician Assistant | 1437 S Gelven Ave, Springfield, MO 65804-2124 | 2019-01-31 |
| 1598265894 | Kelsey L. Magill | Physician Assistant | 3231 S National Ave Ste 440, Springfield, MO 65807-7304 | 2018-02-14 |
| 1447759592 | Darrell Dewain Edwards | Physician Assistant | 4350 S National Ave Ste C200, Springfield, MO 65810-2782 | 2018-02-05 |
| 1164930087 | Ashley Jean Nichole Leutze | Physician Assistant | 1164 E Home Rd Ste J, Springfield, OH 45503-2726 | 2018-01-12 |
| 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.