| Regional Services | |
|
304 E Jackson St #5h Willard MO 65781-9333 | |
| (417) 269-2458 | |
| (417) 269-2465 |
| Full Name | Regional Services |
|---|---|
| Speciality | Family Medicine |
| Location | 304 E Jackson St, Willard, Missouri |
| Authorized Official Name and Position | 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 |
|---|---|
| Regional Services Po Box 505673 Saint Louis MO 63150-5673 Ph: (417) 730-6430 | Regional Services 304 E Jackson St #5h Willard MO 65781-9333 Ph: (417) 269-2458 |
| NPI Number | 1073687299 |
|---|---|
| Provider Enumeration Date | 11/20/2006 |
| Last Update Date | 04/16/2024 |
| Medicare PECOS PAC ID | 5799787784 |
|---|---|
| Medicare Enrollment ID | O20070213000133 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073687299 | NPI | - | NPPES |
| 506215300 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Corbin S Van De Wege |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174713564 PECOS PAC ID: 0345395000 Enrollment ID: I20090901000370 |
| Provider Name | Michelle Marie Spencer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003282864 PECOS PAC ID: 5092022681 Enrollment ID: I20150915000701 |
| Provider Name | Emily Akridge |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659806578 PECOS PAC ID: 7517234271 Enrollment ID: I20170531000174 |
| Provider Name | Soleya Abigail Pippin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396514667 PECOS PAC ID: 2062865314 Enrollment ID: I20240202000717 |
Cox Health Center Willard Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 304 E Jackson St, #b-207, Willard, MO 65781 Phone: 417-269-2458 Fax: 417-269-2465 | |
Cmh Willard Medical Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 502 South Miller Road, Willard, MO 65781 Phone: 417-761-6655 Fax: 417-761-6646 |