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1819 S National Ave Springfield MO 65804-2217 | |
(417) 269-9220 | |
(417) 269-9229 |
Full Name | |
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Speciality | Internal Medicine |
Location | 1819 S National Ave, Springfield, Missouri |
Authorized Official Name and Position | Jonathan 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 505673 Saint Louis MO 63150-5673 Ph: (417) 730-6430 | 1819 S National Ave Springfield MO 65804-2217 Ph: (417) 269-9220 |
NPI Number | 1356068605 |
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Provider Enumeration Date | 10/26/2022 |
Last Update Date | 09/30/2024 |
Medicare PECOS PAC ID | 5799787784 |
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Medicare Enrollment ID | O20070223000002 |
Identifier | Type | State | Issuer |
---|---|---|---|
1356068605 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
207RG0300X | Internal Medicine - Geriatric Medicine | (* (Not Available)) | Primary |
Provider Name | Ovais Zubair |
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Provider Type | Practitioner - Geriatric Psychiatry |
Provider Identifiers | NPI Number: 1598862567 PECOS PAC ID: 5496772691 Enrollment ID: I20051027000414 |
Provider Name | Nabil S Kamel |
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Provider Type | Practitioner - Geriatric Medicine |
Provider Identifiers | NPI Number: 1326080276 PECOS PAC ID: 3577584283 Enrollment ID: I20051209000143 |
Provider Name | William K Rosen |
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Provider Type | Practitioner - Geriatric Medicine |
Provider Identifiers | NPI Number: 1437240520 PECOS PAC ID: 2567535859 Enrollment ID: I20080719000069 |
Provider Name | Levent Akduman |
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Provider Type | Practitioner - Ophthalmology |
Provider Identifiers | NPI Number: 1245344605 PECOS PAC ID: 2860529260 Enrollment ID: I20100415000881 |
Provider Name | Melissa A Gaines |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1376557264 PECOS PAC ID: 4789689191 Enrollment ID: I20160816002981 |
Provider Name | Catharine E Sellers |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1457326738 PECOS PAC ID: 1850342825 Enrollment ID: I20161011000604 |
Provider Name | Stephanie Paige Rich |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1255081253 PECOS PAC ID: 8022405620 Enrollment ID: I20220429000730 |
Provider Name | Sophia Rae Denning |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1689319899 PECOS PAC ID: 6901285824 Enrollment ID: I20220623002948 |
Provider Name | Brittany Vannostrand |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1386219897 PECOS PAC ID: 7113395989 Enrollment ID: I20221129001147 |
Provider Name | Melissa Deanne Knudsen |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1447096508 PECOS PAC ID: 1355887282 Enrollment ID: I20240726001988 |
Provider Name | Carlos Isaac Pacheco Cano |
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Provider Type | Practitioner - Geriatric Medicine |
Provider Identifiers | NPI Number: 1699161190 PECOS PAC ID: 1557615705 Enrollment ID: I20241022000851 |
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 | |
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 | |