DR. MARK J SKELLEY (NPI# 1962479642) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962479642 |
| Entity Type | Individual |
| Full Name | DR. MARK J SKELLEY |
| Credential | MD |
| Practice Address |
3126 S Jackson Ave Suite 102 Joplin MO 64804-2534 |
| Practice Telephone | 4175563400 |
| Practice Fax Number | 4175563401 |
| Mailing Telephone | 4175563400 |
| Mailing Fax Number | 4175563401 |
| Enumeration Date | 2006-03-02 |
| Last Update Date | 2016-10-19 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | R7C50 | MO | Allopathic & Osteopathic Physicians |
| N | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
MDR7C50 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KS | 100135900A | 05 | |
| MO | BLUE CROSS | 25164 | 01 |
| MO | 201844727 | 05 | |
| MO | 201844743 | 05 | |
| OK | 100175490A | 05 |
| Street Address |
3126 S JACKSON AVE SUITE 102 |
| City | JOPLIN |
| State | MO |
| Zip Code | 64804-2534 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851390645 | Paul Milton Olive | Orthopaedic Surgery | 3126 S Jackson Ave, Ste 200, Joplin, MO 64804-2534 | 2005-07-14 |
| 1922427640 | Donna J Schultz | Nurse Practitioner | 3126 S Jackson Ave, Ste 201, Joplin, MO 64804-2534 | 2014-04-09 |
| 1689090888 | Mercy Clinic Joplin LLC | Prosthetic/Orthotic Supplier | 3126 S Jackson Ave, Ste 200, Joplin, MO 64804-2534 | 2014-03-12 |
| 1720403009 | Monica M. Mckee | Physician Assistant | 3126 S Jackson Ave, Ste 101, Joplin, MO 64804-2534 | 2014-02-24 |
| 1225452873 | Rebecca C Moss | Nurse Practitioner | 3126 S Jackson Ave, Ste 101, Joplin, MO 64804-2534 | 2014-02-18 |
| 1366711616 | Anne Michelle Maxey | Family Medicine | 3126 S Jackson Ave, Joplin, MO 64804-2534 | 2011-12-15 |
| 1013204296 | Krishnamraju Kosuru | Pediatrics | 3126 S Jackson Ave, Suite 100, Joplin, MO 64804-2534 | 2011-07-07 |
| 1003103490 | Justin James Dillingham | Family Medicine | 3126 S Jackson Ave, Ste 101, Joplin, MO 64804-2534 | 2011-07-06 |
| 1194801324 | Dennis William Smith | Internal Medicine | 3126 S Jackson Ave, Ste 200, Joplin, MO 64804-2534 | 2006-10-31 |
| 1124136718 | Maria Fe Fiel Bruce | Family Medicine | 3126 S Jackson Ave, Suite 201, Joplin, MO 64804-2534 | 2006-08-25 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033718903 | Lisa Jo Moore | Nurse Practitioner | 2623 S Main Street, Nixa, MO 64804 | 2020-10-22 |
| 1346859600 | Centered and Connected LLC | Counselor | 2401 E 32nd St, Ste 10 #103, Joplin, MO 64804 | 2020-07-23 |
| 1649838780 | Nicole Lynn Egan | Social Worker | 3010 Mcclelland, Joplin, MO 64804 | 2019-06-04 |
| 1902361652 | Redings Mill Internal Care | Clinic/Center | 454 Redings Mill Rd, Joplin, MO 64804 | 2019-02-06 |
| 1447732508 | Urgent Care Travel, Inc | Clinic/Center | 5931 E 32nd Street, Joplin, MO 64804 | 2018-09-05 |
| 1912488891 | Karl G. Keczkemethy | Dietitian, Registered | 100 Mercy Way Ste 570, Joplin, MO 64804 | 2018-08-28 |
| 1790207546 | Jacksie Short | Dentist | 2819 E 29th St, Joplin, MO 64804 | 2017-07-13 |
| 1326574625 | Kristine Kwon Rowland | Nurse Practitioner | 100 Mercy Way Ste 320-330, Joplin, MO 64804 | 2017-05-05 |
| 1942735212 | West R Loveland | Counselor | 3230 S Wisconsin St Suite H, Joplin, MO 64804 | 2017-04-25 |
| 1174070205 | Tracy L Fry | Nurse Practitioner | 3333 Mcintosh Cir Ste 4, Joplin, MO 64804 | 2016-09-07 |
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| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| 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 |
|---|---|---|---|---|
| 1053925537 | Jill Bryant | Internal Medicine | 2615 E 15th St, Joplin, MO 64804-1006 | 2020-09-02 |
| 1770931388 | Ahmed Internal Medicine LLC | Internal Medicine | 3030 Kelley Dr, Joplin, MO 64804-1401 | 2016-05-25 |
| 1528468311 | Healogics Specialty Physicians of Missouri, LLC | Internal Medicine | 1905 W 32nd St Ste 103, Joplin, MO 64804-1594 | 2014-08-28 |
| 1538498035 | Joplin Internal Medicine Clinic | Internal Medicine | 819 E 32nd St, Joplin, MO 64804-2807 | 2009-12-11 |
| 1952638686 | Ronald A. Browning, Inc. | Internal Medicine | 3202 Mcintosh Cir Ste 101, Joplin, MO 64804-3686 | 2009-11-18 |
| 1003041625 | Geoffrey Glen Graham | Internal Medicine | 2024 S Maiden Lane, Suite 204, Joplin, MO 64804-0319 | 2009-05-27 |
| 1346496551 | Thomas Scott Hamilton | Internal Medicine | 2807 Arizona Ave Suite 2, Joplin, MO 64804 | 2008-08-07 |
| 1427154558 | Ricky L Scacewater | Internal Medicine | 100 Mercy Way Ste 450, Joplin, MO 64804-4524 | 2006-09-16 |
| 1972533487 | Kimberly Wood | Internal Medicine | 819 E. 32nd Street, Joplin, MO 64804 | 2006-07-03 |
| 1124055074 | Edgar M. Conrad Iv | Internal Medicine | 2727 E. 32nd St, Ste 1, Joplin, MO 64804 | 2006-06-27 |
| 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.