| Fcc Medical Clinics Llc | |
|
900 State Route Vv Kennett MO 63857-3834 | |
| (573) 559-2365 | |
| (573) 559-2357 |
| Full Name | Fcc Medical Clinics Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 900 State Route Vv, Kennett, Missouri |
| Authorized Official Name and Position | Tracy Ellis (CCO) |
| Authorized Official Contact | 5738885925 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Fcc Medical Clinics Llc Po Box 71 Kennett MO 63857-0071 Ph: (573) 559-2365 | Fcc Medical Clinics Llc 900 State Route Vv Kennett MO 63857-3834 Ph: (573) 559-2365 |
| NPI Number | 1043885254 |
|---|---|
| Provider Enumeration Date | 05/21/2021 |
| Last Update Date | 05/21/2021 |
| Medicare PECOS PAC ID | 1355743741 |
|---|---|
| Medicare Enrollment ID | O20210707003258 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043885254 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
| Provider Name | Andrew C Beach |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1164423935 PECOS PAC ID: 3870402324 Enrollment ID: I20041015000153 |
| Provider Name | Karl E. Shanstrom |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689815201 PECOS PAC ID: 1951570399 Enrollment ID: I20110801000954 |
| Provider Name | Jennifer L Bader |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114277803 PECOS PAC ID: 8123279841 Enrollment ID: I20121106000399 |
| Provider Name | Sarfaraz Jasdanwala |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851646665 PECOS PAC ID: 8426364258 Enrollment ID: I20150825003318 |
| Provider Name | Whitney J Bradford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346736873 PECOS PAC ID: 7315296449 Enrollment ID: I20190625000653 |
Complete Healthcare Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 509 South Byp, Kennett, MO 63857 Phone: 870-243-4650 | |
Twin Rivers Women's Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 509 South Byp, Kennett, MO 63857 Phone: 573-888-0444 Fax: 573-888-0450 | |
Scheidler Rural Health Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 301 South Byp, Kennett, MO 63857 Phone: 573-888-0900 Fax: 573-888-9588 | |
Healthcare For Women, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 304 Teaco Rd, Suite G, Kennett, MO 63857 Phone: 573-888-4370 | |
Massey Family Care Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 304 Teaco Rd, Suite B, Kennett, MO 63857 Phone: 573-888-6100 Fax: 573-888-6184 | |
Fcc Medical Clinics Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 900 State Route Vv, Kennett, MO 63857 Phone: 573-559-2365 Fax: 573-559-2357 |