| Cornerstone Medical, Llc | |
|
2613 S Main St Ste D Joplin MO 64804-2678 | |
| (417) 624-8730 | |
| Not Available |
| Full Name | Cornerstone Medical, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 2613 S Main St Ste D, Joplin, Missouri |
| Authorized Official Name and Position | Joseph Sheppard (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 4173791176 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cornerstone Medical, Llc 2613 S Main St Ste D Joplin MO 64804-2678 Ph: (417) 624-8730 | Cornerstone Medical, Llc 2613 S Main St Ste D Joplin MO 64804-2678 Ph: (417) 624-8730 |
| NPI Number | 1104549948 |
|---|---|
| Provider Enumeration Date | 09/26/2022 |
| Last Update Date | 09/28/2022 |
| Medicare PECOS PAC ID | 4284000183 |
|---|---|
| Medicare Enrollment ID | O20221018001701 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104549948 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Harold D Blankenship |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1003840901 PECOS PAC ID: 2567457518 Enrollment ID: I20050617000010 |
| Provider Name | Bruce Akuna |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326099516 PECOS PAC ID: 0345321774 Enrollment ID: I20080111000202 |
| Provider Name | Joseph Kirk Sheppard |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083901821 PECOS PAC ID: 3375760887 Enrollment ID: I20140806002606 |
| Provider Name | Regan Gass |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467833871 PECOS PAC ID: 5799092177 Enrollment ID: I20190620002114 |
| Provider Name | Deborah J Blinzler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063966802 PECOS PAC ID: 5890082689 Enrollment ID: I20210413001817 |
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