| |
806 Sw Collins Avenue Ava MO 65608 | |
(417) 683-7200 | |
(417) 683-0165 |
Full Name | |
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Speciality | Family Medicine |
Location | 806 Sw Collins Avenue, Ava, Missouri |
Authorized Official Name and Position | Brock Shamel (VICE PRESIDENT) |
Authorized Official Contact | 4172694368 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 802843 Kansas City MO 64180-2843 Ph: (417) 730-6430 | 806 Sw Collins Avenue Ava MO 65608 Ph: (417) 683-7200 |
NPI Number | 1053481689 |
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Provider Enumeration Date | 11/09/2006 |
Last Update Date | 05/17/2021 |
Medicare PECOS PAC ID | 5799787784 |
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Medicare Enrollment ID | O20070206000485 |
Identifier | Type | State | Issuer |
---|---|---|---|
1053481689 | NPI | - | NPPES |
505978502 | Medicaid | MO |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Lorri A Julian-trotter |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1275599599 PECOS PAC ID: 5799757951 Enrollment ID: I20040809000536 |
Provider Name | Renita Randall |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1285724625 PECOS PAC ID: 9739123852 Enrollment ID: I20050620000045 |
Provider Name | Christopher R Spinelli |
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Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1205806312 PECOS PAC ID: 2668495110 Enrollment ID: I20060110001117 |
Provider Name | Susan Graves |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1861581084 PECOS PAC ID: 4183709371 Enrollment ID: I20080312000331 |
Provider Name | Kristina Burton |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1033380381 PECOS PAC ID: 8123107455 Enrollment ID: I20080512000289 |
Provider Name | Brian R Knopf |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1952306110 PECOS PAC ID: 2466510516 Enrollment ID: I20081020000099 |
Provider Name | Levent Akduman |
---|---|
Provider Type | Practitioner - Ophthalmology |
Provider Identifiers | NPI Number: 1245344605 PECOS PAC ID: 2860529260 Enrollment ID: I20100415000881 |
Provider Name | Emily H Mebruer |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1912043316 PECOS PAC ID: 7517090756 Enrollment ID: I20100809000557 |
Provider Name | Tammy L Seifried |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1285924761 PECOS PAC ID: 6002091055 Enrollment ID: I20110506000309 |
Provider Name | Marcia L. Howard |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1437535689 PECOS PAC ID: 1355657834 Enrollment ID: I20150828000661 |
Provider Name | Ibrahim A Alahmad |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1467828202 PECOS PAC ID: 7113291204 Enrollment ID: I20170928002096 |
Provider Name | Cathy Jane Greenlee |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1427537307 PECOS PAC ID: 3870844715 Enrollment ID: I20180917001090 |
Provider Name | Trudi Valynn Marbough |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1417438748 PECOS PAC ID: 4385995539 Enrollment ID: I20180926003635 |
Provider Name | Hannah Lynn Savage |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1336787399 PECOS PAC ID: 6507292208 Enrollment ID: I20200128001770 |
Provider Name | David Paul Tillman |
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Provider Type | Practitioner - Obstetrics/gynecology |
Provider Identifiers | NPI Number: 1356608251 PECOS PAC ID: 6901153212 Enrollment ID: I20200716001778 |
Provider Name | Kendra J Mcmillion |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1235759093 PECOS PAC ID: 6204255698 Enrollment ID: I20201005001382 |
Provider Name | Leann N Rensch |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1417562307 PECOS PAC ID: 7012328081 Enrollment ID: I20201123002505 |
Provider Name | Andrea L Gullett |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1679943377 PECOS PAC ID: 7315256633 Enrollment ID: I20210915000553 |
Provider Name | Jaclyn N Pohlers |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1528407491 PECOS PAC ID: 4587950019 Enrollment ID: I20211021001437 |
Provider Name | Brady Luttrell |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1790814481 PECOS PAC ID: 4880784909 Enrollment ID: I20220211000283 |
Provider Name | Mary Rayborn |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1992865828 PECOS PAC ID: 8820028723 Enrollment ID: I20220421001625 |
Provider Name | Aubri D Ashbacher |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1528677200 PECOS PAC ID: 1557743036 Enrollment ID: I20220729002779 |
Provider Name | Dalton Lusk |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1609500990 PECOS PAC ID: 6103209382 Enrollment ID: I20220822000730 |
Provider Name | Nichole Norgard |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1780213181 PECOS PAC ID: 7618365396 Enrollment ID: I20230925002674 |
Douglas County Health Department Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 603 Nw 12th St, Building C, Ava, MO 65608 Phone: 417-683-4174 Fax: 417-683-4111 | |