- Medicare Primary Care in Willard, MO

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is a medicare enrolled primary clinic (Family Medicine) in Willard, Missouri. The current practice location for is 304 E Jackson St, #5h, Willard, Missouri. For appointments, you can reach them via phone at (417) 269-2458. The mailing address for is Po Box 505673, Saint Louis, Missouri and phone number is (417) 730-6430.

is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1073687299. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (417) 269-2458.

Contact Information

304 E Jackson St
#5h
Willard
MO 65781-9333
(417) 269-2458
(417) 269-2465

Map and Direction


Primary Care Clinic Profile

Full Name
SpecialityFamily Medicine
Location304 E Jackson St, Willard, Missouri
Authorized Official Name and PositionBrock Shamel (VICE PRESIDENT)
Authorized Official Contact4172694368
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address

Po Box 505673
Saint Louis
MO 63150-5673

Ph: (417) 730-6430
304 E Jackson St
#5h
Willard
MO 65781-9333

Ph: (417) 269-2458

NPI Details:

NPI Number1073687299
Provider Enumeration Date11/20/2006
Last Update Date09/30/2024

Medicare PECOS Information:

Medicare PECOS PAC ID5799787784
Medicare Enrollment IDO20070213000133

Medical Identifiers

Medical identifiers for such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1073687299NPI-NPPES
506215300MedicaidMO

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207Q00000XFamily Medicine (* (Not Available))Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. acts as a billing entity for following providers:
Provider NameCorbin S Van De Wege
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1174713564
PECOS PAC ID: 0345395000
Enrollment ID: I20090901000370
Provider NameMichelle Marie Spencer
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1003282864
PECOS PAC ID: 5092022681
Enrollment ID: I20150915000701
Provider NameEmily Akridge
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1659806578
PECOS PAC ID: 7517234271
Enrollment ID: I20170531000174
Provider NameSoleya Abigail Pippin
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1396514667
PECOS PAC ID: 2062865314
Enrollment ID: I20240202000717

Reviews and Comments


Family Medicine in Willard, MO


Primary Care Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 304 E Jackson St, #b-207, Willard, MO 65781
Phone: 417-269-2458    Fax: 417-269-2465

Primary Care Clinic
Medicare: Medicare Enrolled
Practice Location: 502 South Miller Road, Willard, MO 65781
Phone: 417-761-6655    Fax: 417-761-6646

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.