DR. RANDY AGOLIA (NPI# 1972575439) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972575439 |
| Entity Type | Individual |
| Full Name | DR. RANDY AGOLIA |
| Credential | MD |
| Practice Address |
20 Progress Point Pkwy Ste 220 O Fallon MO 63368-2206 |
| Practice Telephone | 6363443333 |
| Practice Fax Number | 6363443334 |
| Mailing Telephone | 6363443333 |
| Mailing Fax Number | 6363443334 |
| Enumeration Date | 2006-02-07 |
| Last Update Date | 2019-06-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 108370 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 200026270 | 05 |
| Street Address |
20 PROGRESS POINT PKWY STE 220 |
| City | O FALLON |
| State | MO |
| Zip Code | 63368-2206 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649273160 | Stephanie L Sandberg | Internal Medicine | 20 Progress Point Pkwy, Suite 206, O Fallon, MO 63368-2206 | 2005-05-30 |
| 1821500778 | Washington University | Durable Medical Equipment & Medical Supplies | 20 Progress Point Pkwy, O Fallon, MO 63368-2206 | 2017-11-01 |
| 1477910461 | Angela C Clercx | Registered Nurse | 20 Progress Point Pkwy, Ste 108, O Fallon, MO 63368-2206 | 2016-01-21 |
| 1366830572 | Wuca-o'fallon Pediatrics, LLC | Pediatrics | 20 Progress Point Pkwy, Suite 220, O Fallon, MO 63368-2206 | 2014-12-23 |
| 1841612850 | Emily Suzanne Hammer | Nurse Practitioner | 20 Progress Point Pkwy, Suite 200, O Fallon, MO 63368-2206 | 2014-01-09 |
| 1629329578 | Susan E Mitchell-derenski | Registered Nurse | 20 Progress Point Pkwy, Ste 100, O Fallon, MO 63368-2206 | 2012-10-01 |
| 1417211756 | Nikol Lei Smart | Obstetrics & Gynecology | 20 Progress Point Pkwy, Ste 206, O Fallon, MO 63368-2206 | 2012-07-02 |
| 1942513205 | Catherine L Crass | Nurse Practitioner | 20 Progress Point Pkwy, Suite 200, O Fallon, MO 63368-2206 | 2010-07-15 |
| 1578875647 | Cory Scott Miller | Obstetrics & Gynecology | 20 Progress Point Pkwy, Ste 206, O Fallon, MO 63368-2206 | 2010-07-06 |
| 1619100989 | Jamie Lee Tueth | Internal Medicine | 20 Progress Point Pkwy, Ste 108, O Fallon, MO 63368-2206 | 2009-09-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134720329 | Come As You Are Counseling LLC | Counselor | 1001 Boardwalk Springs Place, Suite 111, O Fallon, MO 63368 | 2020-11-04 |
| 1770124802 | Lisa N. Greer | Technician | 6911 Brassel Dr., Ofallon, MO 63368 | 2019-09-30 |
| 1770145716 | Halie Faye Gulley | Dentist | 3009 Hwy K, O'fallon, MO 63368 | 2019-06-29 |
| 1972079556 | Erin Corsi Fraundorf | Dentist | 3009 State Hwy K, O'fallon, MO 63368 | 2018-10-22 |
| 1427579960 | Air Evac Ems, Inc. | Ambulance | 1001 Boardwalk Springs Pl Ste 250, O Fallon, MO 63368 | 2017-07-06 |
| 1528507472 | Washeck Manual Therapy LLC | Clinic/Center | 3074 Winghaven Blvd, O'fallon, MO 63368 | 2017-02-13 |
| 1639618457 | Brittany Hogan | Physical Therapist | 7412 South Outer 364, Suite B, Dardenne Prairie, MO 63368 | 2017-02-13 |
| 1124561469 | Cardinal Home Care LLC | Home Health | 18 Convent Garden Ct, O'fallon, MO 63368 | 2016-11-18 |
| 1336509272 | Sarah Marie Mudd | Counselor | 1654 Bryan Road, O'fallon, MO 63368 | 2016-03-04 |
| 1588023956 | Price-bourisaw Family Chiropractic | Chiropractor | 2917 State Highway K, O Fallon, MO 63368 | 2016-02-15 |
| Find all providers in zip 63368 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578792297 | Melissa Roewe | Pediatrics | 9979 Winghaven Blvd Ste 206, O Fallon, MO 63368 | 2009-07-02 |
| 1083842454 | Kimberly N Hackney | Pediatrics | 300 Winding Woods Dr Ste 120, O Fallon, MO 63366-4772 | 2009-06-24 |
| 1881760445 | Thomas Edmund Levrault | Pediatrics | 1337 Park Plaza Dr, Suite 1, O Fallon, IL 62269-1777 | 2006-11-27 |
| 1790730554 | Nuzhat Nisar | Pediatrics | 2954 Highway K, O Fallon, MO 63368-7861 | 2006-05-23 |
| 1881655454 | Jennifer M Hinton | Pediatrics | 1002 Peruque Crossing Ct, Ste 101, O Fallon, MO 63366-2362 | 2006-03-31 |
| 1962478925 | Ella Rozin | Pediatrics | 1001 Highway K, Suite 4, O Fallon, MO 63366-8423 | 2006-02-28 |
| 1013993344 | Guy C Venuti | Pediatrics | 670 Pierce Blvd, O Fallon, IL 62269-2579 | 2005-12-19 |
| 1841281193 | William Stuart Adams | Pediatrics | 9979 Winghaven Blvd, Suite 206, O Fallon, MO 63368-3627 | 2005-11-03 |
| 1619515384 | Emily Caufield | Pediatrics | 604 Pierce Blvd, O Fallon, IL 62269-2588 | 2019-12-12 |
| 1366830572 | Wuca-o'fallon Pediatrics, LLC | Pediatrics | 20 Progress Point Pkwy, Suite 220, O Fallon, MO 63368-2206 | 2014-12-23 |
| Find all providers in O FALLON | ||||
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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.