| Elite Professional Providers, Llc | |
|
3322 S Campbell Ave Ste T-1 Springfield MO 65807-4980 | |
| (417) 220-4482 | |
| (417) 414-0017 |
| Full Name | Elite Professional Providers, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 3322 S Campbell Ave Ste T-1, Springfield, Missouri |
| Authorized Official Name and Position | Shawn Kelley (COO) |
| Authorized Official Contact | 4172204482 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Elite Professional Providers, Llc 2135 E Independence St # 1093 Springfield MO 65804-3749 Ph: (417) 220-4482 | Elite Professional Providers, Llc 3322 S Campbell Ave Ste T-1 Springfield MO 65807-4980 Ph: (417) 220-4482 |
| NPI Number | 1891488433 |
|---|---|
| Provider Enumeration Date | 05/30/2023 |
| Last Update Date | 01/22/2024 |
| Medicare PECOS PAC ID | 1254792740 |
|---|---|
| Medicare Enrollment ID | O20230731003920 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891488433 | NPI | - | NPPES |
| 500128969 | Medicaid | MO |
| Provider Name | Gregoria Villaruel-kirk |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588649651 PECOS PAC ID: 0941233837 Enrollment ID: I20050912000995 |
| Provider Name | Linda C Burdett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639154677 PECOS PAC ID: 3173545886 Enrollment ID: I20051222000049 |
| Provider Name | Christopher W Billings |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124024864 PECOS PAC ID: 8628165834 Enrollment ID: I20081112000019 |
| Provider Name | Thomas E Dahlberg |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013013093 PECOS PAC ID: 6406919604 Enrollment ID: I20090114000594 |
| Provider Name | Lynda K Nickle |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417178906 PECOS PAC ID: 3173665288 Enrollment ID: I20100127000333 |
| Provider Name | Jana Scott |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497028344 PECOS PAC ID: 9234374950 Enrollment ID: I20130401000243 |
| Provider Name | Lee-amy Kathleen Choate |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386162691 PECOS PAC ID: 0143594887 Enrollment ID: I20170920000117 |
| Provider Name | Joseph Adam Reighard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295938934 PECOS PAC ID: 6204174147 Enrollment ID: I20190219001068 |
James M. Carmichael, Dc Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3108 S Fremont Ave, Springfield, MO 65804 Phone: 417-886-4910 Fax: 417-886-4910 | |
Cox Senior Health Center South Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3525 S National Ave, #307, Springfield, MO 65807 Phone: 417-269-9220 Fax: 417-269-9229 | |
The Diagnostic Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3800 S National Ave, #600, Springfield, MO 65807 Phone: 417-269-1499 Fax: 417-269-1459 | |
Cox Senior Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1423 N Jefferson Ave, #k-100, Springfield, MO 65802 Phone: 417-269-3915 Fax: 417-269-3913 | |
Mercy Clinic Hospitalists Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1235 E Cherokee St, Springfield, MO 65804 Phone: 417-820-2600 Fax: 417-820-2100 | |
Elfindale Family Medicine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1429 W Sunshine St, Springfield, MO 65807 Phone: 417-269-2240 Fax: 417-269-2245 | |
Jordan Valley Community Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1720 W Grand St Ste B, Springfield, MO 65802 Phone: 417-831-0150 Fax: 417-831-0155 |