| Hannibal Regional Hospital Physicians | |
|
6000 Hospital Drive Hannibal MO 63401 | |
| (573) 248-1300 | |
| (573) 248-5448 |
| Full Name | Hannibal Regional Hospital Physicians |
|---|---|
| Speciality | Clinic/Center |
| Location | 6000 Hospital Drive, Hannibal, Missouri |
| Authorized Official Name and Position | Robert N Gasaway (VP OF FINANCE) |
| Authorized Official Contact | 5734061608 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Hannibal Regional Hospital Physicians 6000 Hospital Drive Hannibal MO 63401 Ph: (573) 248-1300 | Hannibal Regional Hospital Physicians 6000 Hospital Drive Hannibal MO 63401 Ph: (573) 248-1300 |
| NPI Number | 1003956095 |
|---|---|
| Provider Enumeration Date | 02/07/2007 |
| Last Update Date | 05/25/2021 |
| Medicare PECOS PAC ID | 1254236300 |
|---|---|
| Medicare Enrollment ID | O20031203000229 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003956095 | NPI | - | NPPES |
| 540416005 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Michael A Sedlacek |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1356442313 PECOS PAC ID: 8123916954 Enrollment ID: I20040304001014 |
| Provider Name | Sohail Gulzar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1184682015 PECOS PAC ID: 0446227136 Enrollment ID: I20040913000826 |
| Provider Name | Javed A Choudhry |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1659357184 PECOS PAC ID: 7517917297 Enrollment ID: I20050131000469 |
| Provider Name | Nadine Davis |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1184664708 PECOS PAC ID: 2961453485 Enrollment ID: I20050202000349 |
| Provider Name | James G Osgood |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1235176959 PECOS PAC ID: 2769434109 Enrollment ID: I20050215000063 |
| Provider Name | Donald A Miller |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1003857848 PECOS PAC ID: 3274562152 Enrollment ID: I20050810001233 |
| Provider Name | Michele A Brother |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033153598 PECOS PAC ID: 6204866882 Enrollment ID: I20050813000164 |
| Provider Name | Naina Patil |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1427169390 PECOS PAC ID: 8820021785 Enrollment ID: I20050913000205 |
| Provider Name | Zahid Kaleem |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1063476208 PECOS PAC ID: 4284659483 Enrollment ID: I20051006000734 |
| Provider Name | Howis Yvette Aros |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1033126156 PECOS PAC ID: 8628071214 Enrollment ID: I20060822000108 |
| Provider Name | Hrishikesh P Ghanekar |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1629041686 PECOS PAC ID: 1951317031 Enrollment ID: I20061006000046 |
| Provider Name | Courtney R Graham |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1487759502 PECOS PAC ID: 1951391960 Enrollment ID: I20070417000101 |
| Provider Name | Cheryl Lynn Pilsl |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1700809712 PECOS PAC ID: 1456458249 Enrollment ID: I20070511000459 |
| Provider Name | Luvell L Glanton |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1891717781 PECOS PAC ID: 4981796133 Enrollment ID: I20070817000588 |
| Provider Name | Eli N Denney |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1417161795 PECOS PAC ID: 4284727637 Enrollment ID: I20070830000760 |
| Provider Name | Mark D Snyder |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1790778587 PECOS PAC ID: 1355417395 Enrollment ID: I20080827000633 |
| Provider Name | Mohammad Jarbou |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396830915 PECOS PAC ID: 4385703578 Enrollment ID: I20081103000378 |
| Provider Name | Pranav R Parikh |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1437138997 PECOS PAC ID: 3678624202 Enrollment ID: I20100108000485 |
| Provider Name | Roderick M Bartlett |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1649259300 PECOS PAC ID: 7719029537 Enrollment ID: I20100116000140 |
| Provider Name | Muhammad A Aziz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942466859 PECOS PAC ID: 9133261555 Enrollment ID: I20100123000171 |
| Provider Name | Alicia S Jeffcoat |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1780893123 PECOS PAC ID: 7810029543 Enrollment ID: I20100715000995 |
| Provider Name | Dan H Evans |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1730152273 PECOS PAC ID: 1153387568 Enrollment ID: I20100820000623 |
| Provider Name | Lance W Dorsey |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1073629770 PECOS PAC ID: 0244418564 Enrollment ID: I20110708000425 |
| Provider Name | Hannah Won Lee |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871893552 PECOS PAC ID: 6608059472 Enrollment ID: I20120114000027 |
| Provider Name | Nidal Dabbasi |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1609867464 PECOS PAC ID: 8921270232 Enrollment ID: I20120320000805 |
| Provider Name | Mark D Travis |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1760455281 PECOS PAC ID: 8729138185 Enrollment ID: I20120820000309 |
| Provider Name | Anne Marie Ondak |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1285996009 PECOS PAC ID: 9335398684 Enrollment ID: I20121002000753 |
| Provider Name | Bridget L Moore |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1750600268 PECOS PAC ID: 0941484935 Enrollment ID: I20130411000080 |
| Provider Name | Daanish A. Kazi |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1801003124 PECOS PAC ID: 2567442817 Enrollment ID: I20130726000690 |
| Provider Name | Arham F Hussain |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1619282597 PECOS PAC ID: 0749426583 Enrollment ID: I20130917000065 |
| Provider Name | Tony V Pallan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942512827 PECOS PAC ID: 8325286693 Enrollment ID: I20140103000581 |
| Provider Name | Harsha Desai |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1033325311 PECOS PAC ID: 7113157553 Enrollment ID: I20140304000107 |
| Provider Name | Andrew M Hummel |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1497063705 PECOS PAC ID: 9335366582 Enrollment ID: I20140812000054 |
| Provider Name | Ni Jin |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1114088549 PECOS PAC ID: 8022202993 Enrollment ID: I20140918002676 |
| Provider Name | Keyur V Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1598196826 PECOS PAC ID: 9133348295 Enrollment ID: I20140923000353 |
| Provider Name | Susanne R Owens |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1811259955 PECOS PAC ID: 0345564613 Enrollment ID: I20150114000883 |
| Provider Name | Blake M Kramer |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1255745063 PECOS PAC ID: 4587977731 Enrollment ID: I20150717000965 |
| Provider Name | Megan E Kramer |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1164836979 PECOS PAC ID: 1850608746 Enrollment ID: I20150909001535 |
| Provider Name | Victor A Maalouf |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1073543880 PECOS PAC ID: 2163494238 Enrollment ID: I20151223000582 |
| Provider Name | Omolola Ajoke Omotoso |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1154514529 PECOS PAC ID: 4183781420 Enrollment ID: I20160314000288 |
| Provider Name | Kyle D Hirschman |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1801175401 PECOS PAC ID: 2466686126 Enrollment ID: I20160606001346 |
| Provider Name | Sunita Muranjan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1700071479 PECOS PAC ID: 4486793528 Enrollment ID: I20160802002771 |
| Provider Name | David J Lemons |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1932338753 PECOS PAC ID: 7113212275 Enrollment ID: I20160829001018 |
| Provider Name | Babak Rejaie |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1275574220 PECOS PAC ID: 7618945387 Enrollment ID: I20161207001844 |
| Provider Name | Suzette M Johnson Futrell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871730739 PECOS PAC ID: 0143407965 Enrollment ID: I20161221000829 |
| Provider Name | Vishal K Adma |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1649238221 PECOS PAC ID: 4688576622 Enrollment ID: I20170425002429 |
| Provider Name | Joseph Edward Bass |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1194799338 PECOS PAC ID: 5991730780 Enrollment ID: I20170816003582 |
| Provider Name | Saida M Karimova |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1720499437 PECOS PAC ID: 5890067326 Enrollment ID: I20170818000517 |
| Provider Name | Jan-ake Schultz |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1912002247 PECOS PAC ID: 6608992433 Enrollment ID: I20171030000505 |
| Provider Name | Lori F Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124548177 PECOS PAC ID: 0143580217 Enrollment ID: I20180209001444 |
| Provider Name | Jonathan Lawson |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1992933584 PECOS PAC ID: 5698913390 Enrollment ID: I20180501002435 |
| Provider Name | Walter T Winders |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1841532041 PECOS PAC ID: 7214179704 Enrollment ID: I20180604001193 |
| Provider Name | Eugene Park Chung |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1528030525 PECOS PAC ID: 4486624160 Enrollment ID: I20180827002932 |
| Provider Name | Sofia Iqbal |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154707511 PECOS PAC ID: 2062702970 Enrollment ID: I20180905003270 |
| Provider Name | Hassan Ali |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1629454087 PECOS PAC ID: 2860782711 Enrollment ID: I20180917000109 |
| Provider Name | Ricardo Antonio Rodriguez Mejia |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1508241431 PECOS PAC ID: 7012268303 Enrollment ID: I20180926000620 |
| Provider Name | Ahmad Abou Leila |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1861741126 PECOS PAC ID: 4183993546 Enrollment ID: I20190417000333 |
| Provider Name | Nathan W Simmons |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1740847326 PECOS PAC ID: 5193058154 Enrollment ID: I20190605002629 |
| Provider Name | Vinay Mikkilineni |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1710320189 PECOS PAC ID: 6002116357 Enrollment ID: I20190717001351 |
| Provider Name | Hemal Mahesh Patel |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1063850063 PECOS PAC ID: 8426355918 Enrollment ID: I20190724003123 |
| Provider Name | Janell D Martin |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1194910042 PECOS PAC ID: 4587840541 Enrollment ID: I20190821000692 |
| Provider Name | Ghaila Chinasa Keng |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1952714784 PECOS PAC ID: 9032338108 Enrollment ID: I20190906002993 |
| Provider Name | Gaurav Chaturvedi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073964524 PECOS PAC ID: 0941596563 Enrollment ID: I20191108001586 |
| Provider Name | Rami James Assadi |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1265819478 PECOS PAC ID: 8325343247 Enrollment ID: I20200626001431 |
| Provider Name | Neeraj Singh |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1194160457 PECOS PAC ID: 6709136443 Enrollment ID: I20200709003523 |
| Provider Name | Rajiv Narula |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1982959979 PECOS PAC ID: 6709147689 Enrollment ID: I20200728002017 |
| Provider Name | Brittain U Ladd |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1033647417 PECOS PAC ID: 3779908454 Enrollment ID: I20200729002279 |
| Provider Name | Gary Daniel Peterson |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1831541812 PECOS PAC ID: 7214229517 Enrollment ID: I20200805000109 |
| Provider Name | Ruchir Shah |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1396033437 PECOS PAC ID: 1557656501 Enrollment ID: I20200806000541 |
| Provider Name | Steven Ray Mcafee |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1760896989 PECOS PAC ID: 4486976131 Enrollment ID: I20200820000758 |
| Provider Name | Michael Meng Chen |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1558757757 PECOS PAC ID: 9335424449 Enrollment ID: I20200825001106 |
| Provider Name | Holly M Hardy |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1902431471 PECOS PAC ID: 6901224906 Enrollment ID: I20200908001364 |
| Provider Name | Jason R Howard |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1992192389 PECOS PAC ID: 3375857469 Enrollment ID: I20201112001761 |
| Provider Name | Brian Everett Bendorf |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1962842427 PECOS PAC ID: 4284877457 Enrollment ID: I20201228001856 |
| Provider Name | Colin Schuster |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1033602008 PECOS PAC ID: 0244586378 Enrollment ID: I20210105002104 |
| Provider Name | Adam Rafi |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1356640825 PECOS PAC ID: 2365767134 Enrollment ID: I20210125000907 |
| Provider Name | Alok M Patel |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1457627465 PECOS PAC ID: 5092061788 Enrollment ID: I20210317000483 |
| Provider Name | Ximena Morales |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1477537256 PECOS PAC ID: 9739159039 Enrollment ID: I20210520001060 |
| Provider Name | Richard S Thomas |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1841711959 PECOS PAC ID: 2163793746 Enrollment ID: I20210726003461 |
| Provider Name | Kyle Yuichi Ogami |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1801276571 PECOS PAC ID: 9638471626 Enrollment ID: I20210728003876 |
| Provider Name | Tariq Halasa |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1043754039 PECOS PAC ID: 8729482757 Enrollment ID: I20210812000854 |
| Provider Name | Swati Laroia Coon |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1306284765 PECOS PAC ID: 8224255492 Enrollment ID: I20210826001528 |
| Provider Name | Tammy June Stricker |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1740578939 PECOS PAC ID: 0042481749 Enrollment ID: I20210830002354 |
| Provider Name | Onyedikachi Kenneth Michaels |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1821583584 PECOS PAC ID: 3779989744 Enrollment ID: I20210831002365 |
| Provider Name | Rajamurugan Subramaniyam |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1245783257 PECOS PAC ID: 1850670704 Enrollment ID: I20210908001418 |
| Provider Name | Ryan Daniel Montgomery |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1003346552 PECOS PAC ID: 4385991728 Enrollment ID: I20210910000779 |
| Provider Name | Claire R Smith |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1346745684 PECOS PAC ID: 0446509046 Enrollment ID: I20210929002425 |
| Provider Name | Amin Valliani |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1669559241 PECOS PAC ID: 5193771707 Enrollment ID: I20220114001329 |
| Provider Name | Melanie Winningham |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1588954788 PECOS PAC ID: 9335434752 Enrollment ID: I20220519001444 |
| Provider Name | Alex H Graham |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1932849866 PECOS PAC ID: 1153700059 Enrollment ID: I20220623002339 |
| Provider Name | William Regan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1164576955 PECOS PAC ID: 2860584638 Enrollment ID: I20220628001219 |
| Provider Name | Ghislain B.k. Tchomobe |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720548290 PECOS PAC ID: 7012390479 Enrollment ID: I20220817002166 |
| Provider Name | Robert Sharpe |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1588631329 PECOS PAC ID: 9234168139 Enrollment ID: I20220822000588 |
| Provider Name | Amy Zhang |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881088003 PECOS PAC ID: 1153678321 Enrollment ID: I20220906001945 |
| Provider Name | Matthew Frederic Burke |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457811481 PECOS PAC ID: 4082099791 Enrollment ID: I20220916000674 |
| Provider Name | Nasheed M. Shams |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1134780661 PECOS PAC ID: 8022343458 Enrollment ID: I20221102001602 |
| Provider Name | Vivek Rajani |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1912393091 PECOS PAC ID: 5890084859 Enrollment ID: I20221129000371 |
| Provider Name | Ramakanth K Vemuluri |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1922208222 PECOS PAC ID: 8729258223 Enrollment ID: I20221214001265 |
| Provider Name | Wanda Williams |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720212350 PECOS PAC ID: 1355592916 Enrollment ID: I20221215000889 |
| Provider Name | Jason Robert Divito |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1558604876 PECOS PAC ID: 4183981947 Enrollment ID: I20230217001411 |
| Provider Name | Monjari Gillian |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1265533665 PECOS PAC ID: 4587550876 Enrollment ID: I20230217001437 |
| Provider Name | Jason Grennan |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1457313314 PECOS PAC ID: 9830179092 Enrollment ID: I20230218000082 |
| Provider Name | David Scott Henley |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1770518128 PECOS PAC ID: 2769374032 Enrollment ID: I20230218000088 |
| Provider Name | Jonathan Jaksha |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1871555649 PECOS PAC ID: 3274632054 Enrollment ID: I20230218000114 |
| Provider Name | Steven Todd Mccormack |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1023000338 PECOS PAC ID: 4183651987 Enrollment ID: I20230223000125 |
| Provider Name | Jonathan Grant Reed |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1588653075 PECOS PAC ID: 3577669928 Enrollment ID: I20230224000968 |
| Provider Name | Mohammed F Quraishi |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1871545269 PECOS PAC ID: 8123030814 Enrollment ID: I20230224001081 |
| Provider Name | Stanley R Smith |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1003802968 PECOS PAC ID: 4082527205 Enrollment ID: I20230224001377 |
| Provider Name | Frank Joseph Welte |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1568676948 PECOS PAC ID: 6800933847 Enrollment ID: I20230225000380 |
| Provider Name | Jake Vrdoljak |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1619976230 PECOS PAC ID: 8527253400 Enrollment ID: I20230225000422 |
| Provider Name | Shawn T Stone |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1891040689 PECOS PAC ID: 6103103569 Enrollment ID: I20230225000426 |
| Provider Name | Fang Yu |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1811159296 PECOS PAC ID: 9830214154 Enrollment ID: I20230227000124 |
| Provider Name | Robert William Overstreet |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346956281 PECOS PAC ID: 2466825534 Enrollment ID: I20230310002052 |
| Provider Name | Hussam Fustok |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1740669845 PECOS PAC ID: 5991052995 Enrollment ID: I20230314001216 |
| Provider Name | Nancy Marie Hays |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1437249935 PECOS PAC ID: 1052785219 Enrollment ID: I20230330000678 |
| Provider Name | Kevin W Marcum |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1619166675 PECOS PAC ID: 0042480303 Enrollment ID: I20230621001460 |
| Provider Name | Timothy A Conner |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1750385357 PECOS PAC ID: 6709784119 Enrollment ID: I20230628003723 |
| Provider Name | Kathryn Cambron |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1396749867 PECOS PAC ID: 8224016530 Enrollment ID: I20230628004226 |
| Provider Name | Tamara Mcdonald |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1144355215 PECOS PAC ID: 0244139939 Enrollment ID: I20230913003191 |
| Provider Name | Bruno Chimerem Okoro |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1891314472 PECOS PAC ID: 9931563566 Enrollment ID: I20230914001648 |
| Provider Name | Kunal Agrawal |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1093074122 PECOS PAC ID: 6608160932 Enrollment ID: I20230926000539 |
| Provider Name | Jordan C Calabrese |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1366949976 PECOS PAC ID: 7810379104 Enrollment ID: I20231016000400 |
| Provider Name | Sean Feinberg |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1104273549 PECOS PAC ID: 3476952557 Enrollment ID: I20231020000960 |
| Provider Name | Hongyu Yang |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1750377305 PECOS PAC ID: 2365413945 Enrollment ID: I20231104000554 |
| Provider Name | Sherin Azmy |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1295069680 PECOS PAC ID: 6608174529 Enrollment ID: I20231107001251 |
| Provider Name | Timothy J Maiers |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1386612901 PECOS PAC ID: 4688601784 Enrollment ID: I20231108001798 |
| Provider Name | Jonathan Diaz |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1578856159 PECOS PAC ID: 8224255633 Enrollment ID: I20240104004622 |
| Provider Name | Elizabeth Anne Radcliff |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003679960 PECOS PAC ID: 3476998246 Enrollment ID: I20240302000287 |
Hannibal Regional Medical Group Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 6500 Hospital Dr, Hannibal, MO 63401 Phone: 573-629-3440 Fax: 573-629-3442 | |
Express Care At Walmart Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3650 Stardust Dr, Hannibal, MO 63401 Phone: 573-231-0660 Fax: 573-231-0687 | |
Hannibal Regional Medical Group Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 6500 Hospital Drive, Hannibal, MO 63401 Phone: 573-248-1300 Fax: 573-248-5448 | |
Hannibal Regional Medical Group The Clinic At Walmart Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3650 Stardust Dr, Hannibal, MO 63401 Phone: 573-231-0660 Fax: 573-231-0687 | |
Marion County Health Dept. & Home Health Agency Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3105 Rt. W, Hannibal, MO 63401 Phone: 573-221-1166 Fax: 573-221-1214 | |
Hannibal Clinic Operations, L.l.c Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 100 Medical Dr, Hannibal, MO 63401 Phone: 573-221-5250 Fax: 573-231-3706 |