Ssm Health Medical Group - Family Medicine | |
875 State Route 5 Tipton MO 65081-8441 | |
(660) 433-5541 | |
(660) 433-5717 |
Full Name | Ssm Health Medical Group - Family Medicine |
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Speciality | Clinic/Center |
Location | 875 State Route 5, Tipton, Missouri |
Authorized Official Name and Position | James T Stratton (CFO) |
Authorized Official Contact | 5736813129 |
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) 681-3767 | Ssm Health Medical Group - Family Medicine 875 State Route 5 Tipton MO 65081-8441 Ph: (660) 433-5541 |
NPI Number | 1588601777 |
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Provider Enumeration Date | 05/31/2006 |
Last Update Date | 05/25/2022 |
Medicare PECOS PAC ID | 8921917352 |
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Medicare Enrollment ID | O20041105000902 |
Identifier | Type | State | Issuer |
---|---|---|---|
1588601777 | NPI | - | NPPES |
503469108 | Medicaid | MO |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Provider Name | Gary Baskett |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1922039817 PECOS PAC ID: 0345277141 Enrollment ID: I20050725000001 |
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 | 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 | Nathan T Kenyon |
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Provider Type | Practitioner - Physical Medicine And Rehabilitation |
Provider Identifiers | NPI Number: 1851651657 PECOS PAC ID: 3274768494 Enrollment ID: I20170714002288 |
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 | 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 | Whitney N Bahner |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1326735481 PECOS PAC ID: 7012372659 Enrollment ID: I20230503002277 |