Ssm Health Medical Group - Family Medicine | |
140 Northstar Dr Holts Summit MO 65043-1123 | |
(573) 896-8301 | |
(573) 896-8589 |
Full Name | Ssm Health Medical Group - Family Medicine |
---|---|
Speciality | Clinic/Center |
Location | 140 Northstar Dr, Holts Summit, Missouri |
Authorized Official Name and Position | James T Stratton (CFO) |
Authorized Official Contact | 3093384175 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Ssm Health Medical Group - Family Medicine Po Box 1027 Jefferson City MO 65102-1027 Ph: (573) 768-1376 | Ssm Health Medical Group - Family Medicine 140 Northstar Dr Holts Summit MO 65043-1123 Ph: (573) 896-8301 |
NPI Number | 1952357352 |
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Provider Enumeration Date | 05/26/2006 |
Last Update Date | 10/24/2024 |
Medicare PECOS PAC ID | 8921917352 |
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Medicare Enrollment ID | O20040819000270 |
Identifier | Type | State | Issuer |
---|---|---|---|
1952357352 | NPI | - | NPPES |
502624307 | Medicaid | MO |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | (* (Not Available)) | Primary |
Provider Name | Dennis M Knapik |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1336147602 PECOS PAC ID: 5698785301 Enrollment ID: I20060426000118 |
Provider Name | Garry D Pearson |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1629011812 PECOS PAC ID: 3274630629 Enrollment ID: I20070518000210 |
Provider Name | Christine M Hurt |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1326086752 PECOS PAC ID: 1557444767 Enrollment ID: I20080212000175 |
Provider Name | Treesa R Riedel |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1295140432 PECOS PAC ID: 9537384136 Enrollment ID: I20140715000275 |
Provider Name | Paul E Burris |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1699100255 PECOS PAC ID: 4486881943 Enrollment ID: I20140721001904 |
Provider Name | Christopher A Paynter |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1760749428 PECOS PAC ID: 1153634795 Enrollment ID: I20150724011839 |
Provider Name | Ginger E Protzman |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1104376326 PECOS PAC ID: 9234418005 Enrollment ID: I20161118000335 |
Provider Name | Joanna L Younker |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1114278124 PECOS PAC ID: 1254648025 Enrollment ID: I20170928000503 |
Provider Name | Dayna Lynette Patterson |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1306349261 PECOS PAC ID: 6204184799 Enrollment ID: I20180731001302 |
Provider Name | Michelle Leigh Felten |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1679045595 PECOS PAC ID: 6305170234 Enrollment ID: I20190627000466 |
Provider Name | Samantha Michelle Findley |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1508498601 PECOS PAC ID: 8224466271 Enrollment ID: I20200325001882 |
Provider Name | Renee Jean Scherr |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1386104818 PECOS PAC ID: 4587075296 Enrollment ID: I20201202001306 |
Provider Name | Phillip Plotz |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1992753842 PECOS PAC ID: 5395762660 Enrollment ID: I20220616001063 |
Provider Name | Laura Oberholz |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1396110490 PECOS PAC ID: 8224403639 Enrollment ID: I20230417000431 |
Provider Name | Whitney N Bahner |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1326735481 PECOS PAC ID: 7012372659 Enrollment ID: I20230503002277 |
Capital Region Physicians - Holts Summit Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 180 Northstar St, Holts Summit, MO 65043 Phone: 573-896-5115 Fax: 573-896-4272 |