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121 Cahill Rd Suite 204 Branson MO 65616-1911 | |
| (417) 335-7222 | |
| (417) 335-7224 |
| Full Name | |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 121 Cahill Rd, Branson, Missouri |
| Authorized Official Name and Position | Daniel Roth (VP OF OPERATIONS) |
| Authorized Official Contact | 4172693104 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 505673 Saint Louis MO 63150-5673 Ph: (417) 730-6430 | 121 Cahill Rd Suite 204 Branson MO 65616-1911 Ph: (417) 335-7222 |
| NPI Number | 1417992793 |
|---|---|
| Provider Enumeration Date | 06/19/2006 |
| Last Update Date | 09/30/2024 |
| Certification Date | 09/30/2024 |
| Medicare PECOS PAC ID | 5092624320 |
|---|---|
| Medicare Enrollment ID | O20041204000171 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417992793 | NPI | - | NPPES |
| 507203008 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | 52-48 (Missouri) | Primary |
| Provider Name | Sudhir Batchu |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1871698662 PECOS PAC ID: 5799729570 Enrollment ID: I20050630000220 |
| Provider Name | Diane L Cornelison |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1568406791 PECOS PAC ID: 7517015563 Enrollment ID: I20100921000823 |
| Provider Name | Sabera Shabnam |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144482175 PECOS PAC ID: 2567635873 Enrollment ID: I20120514000104 |
| Provider Name | Ashden M Vogler-blake |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548705189 PECOS PAC ID: 2365723061 Enrollment ID: I20170111000471 |
| Provider Name | Clairese Toma |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1700290574 PECOS PAC ID: 4082947551 Enrollment ID: I20190617000074 |
| Provider Name | David James Haustein |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1003922873 PECOS PAC ID: 8022298546 Enrollment ID: I20210104000386 |
| Provider Name | Azalie Armknecht |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629785506 PECOS PAC ID: 5597133629 Enrollment ID: I20221122000850 |
| Provider Name | Luke Bennett |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1447543772 PECOS PAC ID: 4284953142 Enrollment ID: I20240522000507 |
| Provider Name | Graeme G Boyter |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1649830126 PECOS PAC ID: 8628308822 Enrollment ID: I20240722001626 |
Institute For Beauty And Women's Health Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 590 W Pacific, Branson, MO 65616 Phone: 417-335-2080 Fax: 417-335-2080 | |
Core Therapy & Diagnostics, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 186 S Payne Stewart Dr Ste 151, Branson, MO 65616 Phone: 417-391-3065 | |
Community Christian Counseling Clinic Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 301 W Pacific St Ste D-e, Branson, MO 65616 Phone: 417-425-0983 | |