MISSOURI OBESITY CENTER,LLC (NPI# 1811467053) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811467053 |
| Entity Type | Organization |
| Organization Name | MISSOURI OBESITY CENTER,LLC |
| Practice Address |
1601 E Broadway Ste 160 Columbia MO 65201-5821 |
| Mailing Address |
5102 Beacon Falls Dr Columbia MO 65203-9056 |
| Practice Telephone | 5737779917 |
| Practice Fax Number | 5737779918 |
| Mailing Telephone | 4179885306 |
| Enumeration Date | 2018-11-30 |
| Last Update Date | 2018-11-30 |
| Authorized Official Name | DR. CHARLES KONTOR WIREDU (OWNER) |
| Authorized Official Telephone | 4179885306 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RE0101X |
Internal Medicine Specialization: Endocrinology, Diabetes & Metabolism |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Wiredu Endocrinology | Doing Business As Name - Organization |
| Street Address |
1601 E BROADWAY STE 160 |
| City | COLUMBIA |
| State | MO |
| Zip Code | 65201-5821 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205459203 | Serenity Sleep Solutions of Missouri LLC | Durable Medical Equipment & Medical Supplies | 1601 E Broadway Ste 160, Columbia, MO 65201-5821 | 2020-05-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134688534 | Thomas Havey | Specialist/Technologist | 600 E Stadium Boulevard, Columbia, MO 65201 | 2019-03-15 |
| 1881176121 | Darrea L Green | Nurse Practitioner | 3700 Interstate 70 Dr Se, Columbia, MO 65201 | 2018-09-04 |
| 1073092383 | Andrea L. Lingenfelter | Registered Nurse | 1605 East Broadway, Ste. 100, Columbia, MO 65201 | 2018-08-08 |
| 1144724238 | Angela Marie Richmond | Internal Medicine | 1 Hospital Dr Rm Ma423, Columbia, MO 65201 | 2018-03-22 |
| 1770092892 | Palmer's Home Care, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 701 Hillsdale Road, Columbia, MO 65201 | 2017-09-20 |
| 1205358710 | Mitchell E Swee | Specialist/Technologist | 600 East Stadium Blvd, Columbia, MO 65201 | 2017-07-17 |
| 1659815470 | Colleen Jockin | Specialist | 100 Matc, Columbia, MO 65201 | 2016-12-13 |
| 1720535305 | Hannah Garrad | Dietitian, Registered | Columbia 3, 25 Conley Road, Columbia, MO 65201 | 2016-09-01 |
| 1043662570 | Restoration Chiropractic LLC | Chiropractor | 1413 Grindstone Plaza Drive, Columbia, MO 65201 | 2016-07-08 |
| 1306298930 | Taylor John Sirois | Chiropractor | 1413 Grindstone Plaza Dr., Columbia, MO 65201 | 2016-07-07 |
| Find all providers in zip 65201 | ||||
| Taxonomy Code | 207RE0101X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Endocrinology, Diabetes & Metabolism |
| An internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306183264 | Leonard Peter Kapcala | Internal Medicine | 7158 Rivers Edge Rd, Columbia, MD 21044-4235 | 2013-01-12 |
| 1356575229 | Javzandulam Natsag | Internal Medicine | 10710 Charter Dr Ste 410, Suite 410, Columbia, MD 21044-3276 | 2009-05-07 |
| 1558575043 | Leo Lauhon Walker | Internal Medicine | 2417 Bermuda Hills Rd, Columbia, SC 29223-6807 | 2007-05-10 |
| 1962480590 | Ambika Rao | Internal Medicine | 6439 Garners Ferry Road, Bldg 100, Rm5c100b, Columbia, SC 29209-1613 | 2006-01-04 |
| 1487655213 | Anastacio G Herrera Jr. | Internal Medicine | 40 Grant Ln, Columbia, KY 42728-2233 | 2005-08-02 |
| 1902203326 | Ronald L. Johnson, M.d., LLC | Internal Medicine | 4100 N Main St, Suite 201, Columbia, SC 29203-5800 | 2014-12-01 |
| 1033559604 | Venkata Sai B Chinnakotla | Internal Medicine | 3315 Berrywood Dr, Columbia, MO 65201-6571 | 2013-06-27 |
| 1497020564 | David Levitt | Internal Medicine | 10710 Charter Dr Ste 410, Columbia, MD 21044 | 2012-03-21 |
| 1881826832 | Ribal Al Aridi | Internal Medicine | 2 Medical Park Rd Ste 506, Columbia, SC 29203-6876 | 2009-08-10 |
| 1386886414 | Luz Catherine Tello | Internal Medicine | 10710 Charter Dr, Suite 410, Columbia, MD 21044-3128 | 2009-04-06 |
| Find all providers in COLUMBIA | ||||
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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.