| Family Medical Clinic | |
|
1700 Nw Mock Ave Blue Springs MO 64015-3118 | |
| (816) 224-0400 | |
| (816) 224-0418 |
| Full Name | Family Medical Clinic |
|---|---|
| Speciality | Family Medicine |
| Location | 1700 Nw Mock Ave, Blue Springs, Missouri |
| Authorized Official Name and Position | Russell Jay Thornton (OWNER) |
| Authorized Official Contact | 8162240400 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Medical Clinic 1700 Nw Mock Ave Blue Springs MO 64015-3118 Ph: (816) 224-0400 | Family Medical Clinic 1700 Nw Mock Ave Blue Springs MO 64015-3118 Ph: (816) 224-0400 |
| NPI Number | 1699708842 |
|---|---|
| Provider Enumeration Date | 07/09/2006 |
| Last Update Date | 02/12/2020 |
| Medicare PECOS PAC ID | 0042213613 |
|---|---|
| Medicare Enrollment ID | O20060821000516 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699708842 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 105481 (Missouri) | Primary |
| Provider Name | Russell J Thornton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205896685 PECOS PAC ID: 5496651697 Enrollment ID: I20031209000672 |
| Provider Name | Michael G Francis |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1801951470 PECOS PAC ID: 9032249198 Enrollment ID: I20100616000444 |
| Provider Name | Janene M Nalivaiko |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366853673 PECOS PAC ID: 8527281310 Enrollment ID: I20140523001107 |
| Provider Name | Tami J Thornton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841683323 PECOS PAC ID: 6406859081 Enrollment ID: I20151022000167 |
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