| Bhg Xxviii, Llc | |
|
1639 Bruce Smith Pkwy West Plains MO 65775-7691 | |
| (417) 257-1833 | |
| (417) 256-0488 |
| Full Name | Bhg Xxviii, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1639 Bruce Smith Pkwy, West Plains, Missouri |
| Authorized Official Name and Position | Jemece Michelle Gasaway (DIRECTOR OF LICENSING) |
| Authorized Official Contact | 2143656126 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bhg Xxviii, Llc 5001 Spring Valley Road Suite 600 East Dallas TX 75244-3946 Ph: (214) 365-6100 | Bhg Xxviii, Llc 1639 Bruce Smith Pkwy West Plains MO 65775-7691 Ph: (417) 257-1833 |
| NPI Number | 1164833877 |
|---|---|
| Provider Enumeration Date | 05/15/2014 |
| Last Update Date | 02/20/2019 |
| Medicare PECOS PAC ID | 9032429741 |
|---|---|
| Medicare Enrollment ID | O20151110000435 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164833877 | NPI | - | NPPES |
| Provider Name | Celeste Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689650855 PECOS PAC ID: 5991787608 Enrollment ID: I20040607000064 |
| Provider Name | Daniel L Strode |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1578636734 PECOS PAC ID: 9032138896 Enrollment ID: I20051122000293 |
| Provider Name | Sonja Williams |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1609836857 PECOS PAC ID: 3870590946 Enrollment ID: I20061102000305 |
| Provider Name | Elaine Blevins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245471994 PECOS PAC ID: 0042351397 Enrollment ID: I20100108000150 |
| Provider Name | Becky A Cumley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194966713 PECOS PAC ID: 6608193826 Enrollment ID: I20150327001849 |
| Provider Name | William Carpenter |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1164787594 PECOS PAC ID: 9032345400 Enrollment ID: I20151211000481 |
| Provider Name | Shawn M Stranckmeyer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558776229 PECOS PAC ID: 4688946064 Enrollment ID: I20170818002923 |
| Provider Name | Sarah Marie Canoy |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1639529746 PECOS PAC ID: 3274826557 Enrollment ID: I20200107001288 |
| Provider Name | Lisa Hendrix |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497833610 PECOS PAC ID: 3678566023 Enrollment ID: I20220308002343 |
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