| Bethany Medical Clinic | |
|
3202 Miller St Bethany MO 64424-2713 | |
| (660) 425-3154 | |
| (660) 425-6663 |
| Full Name | Bethany Medical Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 3202 Miller St, Bethany, Missouri |
| Authorized Official Name and Position | Christina Gillespie (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 6604252211 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bethany Medical Clinic 3202 Miller St Bethany MO 64424-2713 Ph: (660) 425-3154 | Bethany Medical Clinic 3202 Miller St Bethany MO 64424-2713 Ph: (660) 425-3154 |
| NPI Number | 1154645745 |
|---|---|
| Provider Enumeration Date | 03/25/2010 |
| Last Update Date | 09/21/2021 |
| Certification Date | 09/21/2021 |
| Medicare PECOS PAC ID | 4587630926 |
|---|---|
| Medicare Enrollment ID | O20040907001047 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154645745 | NPI | - | NPPES |
| 598581601 | Medicaid | MO | |
| 43650011 | Other | MO | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Secondary |
| 261QR1300X | Clinic/center - Rural Health | () | Primary |
| Provider Name | Danny W Bartlett |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538147046 PECOS PAC ID: 4880679075 Enrollment ID: I20040622000665 |
| Provider Name | Gregory Alan Dean |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568430437 PECOS PAC ID: 8224082441 Enrollment ID: I20050323001410 |
| Provider Name | David Fox |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689639619 PECOS PAC ID: 4082503297 Enrollment ID: I20051128000522 |
| Provider Name | Paul M Rosenthal |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528020039 PECOS PAC ID: 2163310392 Enrollment ID: I20070830000496 |
| Provider Name | Kyle a Cassias |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1093881500 PECOS PAC ID: 1355416058 Enrollment ID: I20080814000432 |
| Provider Name | Tamula K Maxwell |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1255303681 PECOS PAC ID: 3274537170 Enrollment ID: I20100626000357 |
| Provider Name | Arihant Jain |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396910469 PECOS PAC ID: 6709910086 Enrollment ID: I20100823000848 |
| Provider Name | Marc K Taormina |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1992788038 PECOS PAC ID: 3476467572 Enrollment ID: I20111123000671 |
| Provider Name | Cephas C Paniamogan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053601716 PECOS PAC ID: 8022273994 Enrollment ID: I20120626000664 |
| Provider Name | Kenneth Chad Lambert |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063704161 PECOS PAC ID: 2365699691 Enrollment ID: I20120821001117 |
| Provider Name | Wyatt-dean a Pickering |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1316178874 PECOS PAC ID: 8325194145 Enrollment ID: I20140822000752 |
| Provider Name | Francisco J Aleman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356618177 PECOS PAC ID: 2365660941 Enrollment ID: I20140822001151 |
| Provider Name | Aaron Lee Rowland |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760405260 PECOS PAC ID: 2961413745 Enrollment ID: I20140903000112 |
| Provider Name | David M Whitmer |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1568789519 PECOS PAC ID: 1658522057 Enrollment ID: I20141013001120 |
| Provider Name | Jeremiah E Yerton |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1568682722 PECOS PAC ID: 5193856920 Enrollment ID: I20141216000082 |
| Provider Name | Brian J Spinks |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1538429360 PECOS PAC ID: 0840510574 Enrollment ID: I20160801001562 |
| Provider Name | Vincent R Hamo |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1215391966 PECOS PAC ID: 3577852490 Enrollment ID: I20180808000882 |
| Provider Name | Mohammad M Hassan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326049420 PECOS PAC ID: 9739121781 Enrollment ID: I20181029000139 |
| Provider Name | John M Rayburn |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1346275302 PECOS PAC ID: 9638151616 Enrollment ID: I20190321000779 |
| Provider Name | Madhuresh Kumar |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1356362792 PECOS PAC ID: 5496882466 Enrollment ID: I20190405000355 |
| Provider Name | Kelly Ann Clark |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164062972 PECOS PAC ID: 7911335864 Enrollment ID: I20200309000271 |
| Provider Name | Ashley Anne Harding |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649660812 PECOS PAC ID: 6901124148 Enrollment ID: I20200309000598 |
| Provider Name | Scott a Corcoran |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1972588663 PECOS PAC ID: 4183668197 Enrollment ID: I20201221002645 |
| Provider Name | Kimberly R Baker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043693104 PECOS PAC ID: 1254648132 Enrollment ID: I20220504001155 |
| Provider Name | Alexander Kilburn Visk |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1508429895 PECOS PAC ID: 7911301528 Enrollment ID: I20220609001322 |
| Provider Name | Carl L Falcone |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1801954144 PECOS PAC ID: 3971491127 Enrollment ID: I20230104002689 |
| Provider Name | Jeanette Dilan-koetje |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538499454 PECOS PAC ID: 5294979399 Enrollment ID: I20230915001328 |
| Provider Name | Bret D Heileson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912982075 PECOS PAC ID: 5496740573 Enrollment ID: I20240222001896 |
| Provider Name | Hallie Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366283269 PECOS PAC ID: 5698216422 Enrollment ID: I20240920000735 |
| Provider Name | Madeline G Schulte |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952186173 PECOS PAC ID: 9638680473 Enrollment ID: I20250618000294 |
| Provider Name | Adnan Islam |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1033850284 PECOS PAC ID: 0648650507 Enrollment ID: I20250728000167 |
| Provider Name | Racheal Davidson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1821739962 PECOS PAC ID: 7911387865 Enrollment ID: I20260403002791 |
| Provider Name | Jared Schreiner |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1205095494 PECOS PAC ID: 7113119371 Enrollment ID: I20260514004015 |
Bethany Health Services Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 903 N 25th St, Bethany, MO 64424 Phone: 660-425-7333 Fax: 660-425-7346 |
Harrison County Family Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2703 Miller St, Bethany, MO 64424 Phone: 660-425-7443 Fax: 660-425-6516 |
Infinity Health Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2600 Miller St, Bethany, MO 64424 Phone: 414-462-3836 |
Terry E Hall MD Rhc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2703 Miller St, Bethany, MO 64424 Phone: 660-425-7443 Fax: 660-425-6516 |
North Missouri Family Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2703 Miller St, Bethany, MO 64424 Phone: 660-425-7443 Fax: 660-425-6516 |
Bethany Medical Rural Health Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3202 Miller St, Bethany, MO 64424 Phone: 660-425-3154 Fax: 660-425-6663 |