MISSOURI SOUTHERN STATE UNIVERSITY (NPI# 1902357379) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902357379 |
| Entity Type | Organization |
| Organization Name | MISSOURI SOUTHERN STATE UNIVERSITY |
| Other Organization Name | MISSOURI SOUTHERN STATE UNIVERSITY SPORTS MEDICINE |
| Practice Address |
3950 Newman Rd Joplin MO 64801-1512 |
| Mailing Address |
5050 Spring Valley Rd. Dallas TX 75244 |
| Practice Telephone | 4176259300 |
| Enumeration Date | 2016-10-20 |
| Last Update Date | 2016-10-20 |
| Authorized Official Name | MOUZON BASS III (AGENT) |
| Authorized Official Telephone | 9723674845 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207X00000X | Orthopaedic Surgery | 112693 | MO | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Missouri Southern State University Sports Medicine | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | Missouri Southern State University | 3950 E Newman Rd, Joplin, MO 64801 |
| System for Award Management (SAM) Entities | MISSOURI SOUTHERN STATE UNIVERSITY | 3950 Newman Rd, Joplin, MO 64801-1512 |
| Street Address |
3950 NEWMAN RD |
| City | JOPLIN |
| State | MO |
| Zip Code | 64801-1512 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235187337 | Amanda Carol Wolf | Specialist/Technologist | 3950 Newman Rd, Joplin, MO 64801-1512 | 2006-05-04 |
| 1528548120 | Brandon Myers | Specialist/Technologist | 3950 Newman Rd, Joplin, MO 64801-1512 | 2018-08-14 |
| 1831696996 | Logan Van Veen | Specialist/Technologist | 3950 Newman Rd, Joplin, MO 64801-1512 | 2018-04-06 |
| 1891292876 | Lauryn Leininger | Specialist/Technologist | 3950 Newman Rd, Joplin, MO 64801-1512 | 2018-04-06 |
| 1659877744 | Holly Wofford | Specialist/Technologist | 3950 Newman Rd, Joplin, MO 64801-1512 | 2018-04-05 |
| 1801275466 | Harley Grant Beck | Rehabilitation Unit | 3950 Newman Rd, Joplin, MO 64801-1512 | 2015-05-28 |
| 1497908842 | Missouri Southern State University Health Center | Clinic/Center | 3950 Newman Rd, Kuhn Hall 306 Health Services Office, Joplin, MO 64801-1512 | 2008-10-29 |
| 1891982922 | Julie Rachelle Stamps | Nurse Practitioner | 3950 Newman Rd, Joplin, MO 64801-1512 | 2007-10-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235747783 | Chelsea Marie Wilson | Speech-Language Pathologist | Kaleidoscope Clinic 3531 N Range Line Rd, Joplin, MO 64801 | 2020-07-21 |
| 1639669807 | Cassandra Lee Williams | Speech-Language Pathologist | 310 W 8th Street, Joplin, MO 64801 | 2018-05-14 |
| 1427593177 | Healthone Labs LLC | Clinical Medical Laboratory | 101 N Rangline Rd, 304, Joplin, MO 64801 | 2017-01-04 |
| 1902253768 | Options Outpaitent Counseling Service | Counselor | 1515 W 10th St., Suite E, Joplin, MO 64801 | 2016-05-20 |
| 1467833871 | Regan Gass | Nurse Practitioner | 2912 West 16th Street, Joplin, MO 64801 | 2015-06-11 |
| 1881091171 | Pamela Ann Younger | Dental Hygienist | 530 S Maiden Lane, Joplin, MO 64801 | 2014-12-02 |
| 1588908065 | Amy Maria Manrique | Counselor | 301 E. Virginia Street, Joplin, MO 64801 | 2012-11-21 |
| 1356612329 | Ideal Care Clinical Services, LLC | Pharmacy | 5898 North Main, Suite 109, Joplin, MO 64801 | 2012-01-23 |
| 1124256037 | Nathalie Grace Canete Husain | Physical Therapist | Gmmpcpi 214 West 5th St., Suite D & E, Joplin, MO 64801 | 2009-06-30 |
| 1912162447 | David Odinga Egessah | Occupational Therapist | 214 West 5th St, Gmm Procare Providers Inc, Joplin, MO 64801 | 2008-07-24 |
| Find all providers in zip 64801 | ||||
| Taxonomy Code | 207X00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720281330 | David Edward Eisenhauer | Orthopaedic Surgery | 100 Mercy Way Ste 430, Joplin, MO 64804-4524 | 2007-06-10 |
| 1033127543 | David A. Ball | Orthopaedic Surgery | 1111 Mc Intosh Cir, Joplin, MO 64804-3645 | 2006-08-03 |
| 1699706887 | Derek Wade Miller | Orthopaedic Surgery | 3105 Mcclelland Blvd., Joplin, MO 64804-1640 | 2006-07-05 |
| 1235133679 | David L Black | Orthopaedic Surgery | 3105 Mcclelland Blvd, Joplin, MO 64804-1640 | 2005-06-13 |
| 1730443961 | Thomas L. Sanders Jr. | Orthopaedic Surgery | 3105 Mcclelland Blvd, Joplin, MO 64804-1640 | 2012-07-03 |
| 1285856955 | Todd Joseph Twiss | Orthopaedic Surgery | 3105 Mcclelland Blvd, Joplin, MO 64804-1640 | 2007-05-03 |
| 1174684229 | Adam D. Kessler | Orthopaedic Surgery | 3105 Mcclelland Blvd, Joplin, MO 64804-1640 | 2006-12-13 |
| 1053419291 | Bruce W. Burleigh | Orthopaedic Surgery | 932 E 34th St, Joplin, MO 64804-3932 | 2006-09-20 |
| 1588617278 | Midwest Orthopaedic Surgery Inc | Orthopaedic Surgery | 3105 Mcclelland Blvd, Joplin, MO 64804-1640 | 2006-05-17 |
| 1407838469 | Thomas D Mcclain | Orthopaedic Surgery | 3126 S Jackson Ave, Suite 200, Joplin, MO 64804-2534 | 2005-11-16 |
| Find all providers in JOPLIN | ||||
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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.