Robert J Boulware (NPI# 1801978259, PAC ID# 9335133586) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is INTERNAL MEDICINE.
| Nation Provider ID (NPI) | 1801978259 |
| PAC ID by PECOS | 9335133586 |
| Professional Enrollment ID | I20040415001199 |
| Full Name | Robert J Boulware |
| Organization Legal Name | GLADSTONE URGENT CARE, LLC |
| Address |
7642 N Oak Trfy Gladstone MO 64118-1751 |
| Phone Number | 8164681411 |
| Gender | M |
| Credential | MD |
| Medical School | UNIVERSITY OF MISSOURI, KANSAS CITY, SCHOOL OF MEDICINE |
| Graduation Year | 1990 |
| Primary Specialty | INTERNAL MEDICINE |
| Group Practice PAC ID | 1052613007 |
| Number of Group Practice Members | 2 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 260096 | NORTH KANSAS CITY HOSPITAL |
| 260177 | NEW LIBERTY HOSPITAL DISTRICT |
| 261321 | HEDRICK MEDICAL CENTER |
| 260062 | SAINT LUKES NORTH HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 7642 N Oak Trfy, Gladstone, MO 64118-1751 | 8164681411 | GLADSTONE URGENT CARE, LLC |
| 1131 W Kansas, Liberty, MO 64068-2281 | 8167925577 | BOULWARE MEDICAL CLINIC L.L.C. |
| Organization Legal Name | GLADSTONE URGENT CARE, LLC |
| Physicians | 2 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Dixie Sue Manroe | Nurse Practitioner | Gladstone Urgent Care, LLC | 7642 N Oak Trfy, Gladstone, MO 64118-1751 |
| Street Address |
7642 N OAK TRFY |
| City | GLADSTONE |
| State | MO |
| Zip | 64118-1751 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Dixie Sue Manroe | Nurse Practitioner | Gladstone Urgent Care, LLC | 7642 N Oak Trfy, Gladstone, MO 64118-1751 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Blake M Overly | Chiropractic | 8002 N Oak Trfy, Suite 112, Kansas City, MO 64118-1272 | |
| Mary Jo Hegstrom | Physical Therapy | Serc Rehabilitation Partners LLC | 7932 N Oak Trfy, 212 Serc Metro North, Kansas City, MO 64118-1424 |
| Jessica Elise Winberry | Physical Therapy | Serc Rehabilitation Partners LLC | 7932 N Oak Trfy, 212 Serc Metro North, Kansas City, MO 64118-1424 |
| Angela Marie Nickell | Physical Therapy | Serc Rehabilitation Partners LLC | 7932 N Oak Trfy, 212 Serc Metro North, Kansas City, MO 64118-1424 |
| Kayla Ubel Lingenfelter | Physical Therapy | Serc Rehabilitation Partners LLC | 7932 N Oak Trfy, 212 Serc Metro North, Kansas City, MO 64118-1424 |
| Jaron Thomas Perry | Physical Therapy | Serc Rehabilitation Partners LLC | 7932 N Oak Trfy, 212 Serc Metro North, Kansas City, MO 64118-1424 |
| Vanessa Gail Shaw | Physical Therapy | Serc Rehabilitation Partners LLC | 7932 N Oak Trfy, 212 Serc Metro North, Kansas City, MO 64118-1424 |
| Ashley Marie Fotiadis | Physical Therapy | Serc Rehabilitation Partners LLC | 7932 N Oak Trfy, 212 Serc Metro North, Kansas City, MO 64118-1424 |
| Frank P Siraguso Jr. | Chiropractic | 7825 N Oak Trfy, Kansas City, MO 64118-1426 | |
| Christina M Ebert | Clinical Social Worker | 21 Nw 78th Ter, Kansas City, MO 64118-1456 | |
| Find all physicians in zip 64118 | |||
| City | GLADSTONE |
| Zip Code | 64118 |
| Specialty | INTERNAL MEDICINE |
| City + Specialty | GLADSTONE + INTERNAL MEDICINE |
Please comment or provide details below to improve the information on Robert J Boulware.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.