| Hannibal Regional Medical Group | |
|
6500 Hospital Drive Hannibal MO 63401-1239 | |
| (573) 248-1300 | |
| (573) 248-5448 |
| Full Name | Hannibal Regional Medical Group |
|---|---|
| Speciality | Clinic/Center |
| Location | 6500 Hospital Drive, Hannibal, Missouri |
| Authorized Official Name and Position | Rob 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 Medical Group Po Box 1239 Hannibal MO 63401-1239 Ph: (573) 248-1300 | Hannibal Regional Medical Group 6500 Hospital Drive Hannibal MO 63401-1239 Ph: (573) 248-1300 |
| NPI Number | 1134311392 |
|---|---|
| Provider Enumeration Date | 08/13/2007 |
| Last Update Date | 05/25/2021 |
| Medicare PECOS PAC ID | 1254236300 |
|---|---|
| Medicare Enrollment ID | O20071004000422 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134311392 | NPI | - | NPPES |
| 507544203 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Forest R Conley |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1982603452 PECOS PAC ID: 9032012844 Enrollment ID: I20040129000554 |
| Provider Name | Hung N Winn |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1962457374 PECOS PAC ID: 1951389626 Enrollment ID: I20040709000386 |
| Provider Name | Barbara A White |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1629057120 PECOS PAC ID: 7618929134 Enrollment ID: I20050420000155 |
| Provider Name | Alice V Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598741621 PECOS PAC ID: 4587607072 Enrollment ID: I20050606000885 |
| Provider Name | Laura Md Maple |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1740269307 PECOS PAC ID: 8022046481 Enrollment ID: I20050728000069 |
| Provider Name | Donald A Miller |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1003857848 PECOS PAC ID: 3274562152 Enrollment ID: I20050810001233 |
| Provider Name | Kelly D Burchett |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1629161864 PECOS PAC ID: 0345272837 Enrollment ID: I20050906000715 |
| Provider Name | Michael Steven Cardwell |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1063419638 PECOS PAC ID: 9830103324 Enrollment ID: I20060206000065 |
| Provider Name | John P Greving |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1043388036 PECOS PAC ID: 8729054119 Enrollment ID: I20070316000214 |
| Provider Name | Rebecca P Gibson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528067097 PECOS PAC ID: 1355440553 Enrollment ID: I20070629000238 |
| Provider Name | John C Collins |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689659559 PECOS PAC ID: 4789697947 Enrollment ID: I20070629000521 |
| 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 | Edward A Cline |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1306849971 PECOS PAC ID: 2365538691 Enrollment ID: I20071018000389 |
| Provider Name | Richard P Valuck |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1366444549 PECOS PAC ID: 9436245669 Enrollment ID: I20071018000415 |
| Provider Name | Robert T Troiani |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1891736591 PECOS PAC ID: 5496733826 Enrollment ID: I20080523000503 |
| Provider Name | Mohammad Jarbou |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396830915 PECOS PAC ID: 4385703578 Enrollment ID: I20081103000378 |
| Provider Name | Justin D Puckett |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205044146 PECOS PAC ID: 6103978101 Enrollment ID: I20090722000758 |
| Provider Name | Michael Tentori |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932227907 PECOS PAC ID: 0749333094 Enrollment ID: I20090804000216 |
| Provider Name | Purvi Parikh |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1346229838 PECOS PAC ID: 4082754353 Enrollment ID: I20091217000055 |
| 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 | Linda D Carleton |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1427028190 PECOS PAC ID: 7113069915 Enrollment ID: I20100115000894 |
| Provider Name | John R Bennett |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1457330128 PECOS PAC ID: 0446392260 Enrollment ID: I20100116000144 |
| Provider Name | Scott A Gard |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1659316990 PECOS PAC ID: 1052314721 Enrollment ID: I20100504000460 |
| Provider Name | Thomas A Bragg |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790891885 PECOS PAC ID: 3870621964 Enrollment ID: I20100511000683 |
| Provider Name | Nola F Moore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063529006 PECOS PAC ID: 1850421363 Enrollment ID: I20100610000022 |
| Provider Name | Vivian M Hall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023159514 PECOS PAC ID: 9931231586 Enrollment ID: I20100716000337 |
| Provider Name | Dennis L Smith |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1952331910 PECOS PAC ID: 8022197938 Enrollment ID: I20100806000804 |
| Provider Name | Gary Michael Early |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215913132 PECOS PAC ID: 1355465444 Enrollment ID: I20100826000083 |
| Provider Name | Jan F Onik |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982604930 PECOS PAC ID: 5890868111 Enrollment ID: I20100901000085 |
| Provider Name | Connie M Dochterman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578578316 PECOS PAC ID: 4284759499 Enrollment ID: I20100910001123 |
| Provider Name | Erick O Calmet Del Castillo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447401716 PECOS PAC ID: 9032234695 Enrollment ID: I20100920000466 |
| Provider Name | Teresa L Tucker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083826762 PECOS PAC ID: 0648396945 Enrollment ID: I20100923001093 |
| Provider Name | Adam J Samaritoni |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013117498 PECOS PAC ID: 2769674134 Enrollment ID: I20101005000287 |
| Provider Name | Saulat Mushtaq |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518080605 PECOS PAC ID: 2668666298 Enrollment ID: I20101027001540 |
| Provider Name | Jeanette M Keller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366745713 PECOS PAC ID: 3678761921 Enrollment ID: I20101230000651 |
| Provider Name | Ashraf Almashhrawi |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1447247077 PECOS PAC ID: 5092704643 Enrollment ID: I20110722000267 |
| Provider Name | Khulood T Ahmed |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1588827893 PECOS PAC ID: 7810168853 Enrollment ID: I20110922000320 |
| Provider Name | Julie J Viehmann |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1457512089 PECOS PAC ID: 4284883315 Enrollment ID: I20121005000301 |
| Provider Name | Sherry L Masterson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861736449 PECOS PAC ID: 1052564671 Enrollment ID: I20130110000268 |
| Provider Name | Kayla Ann Payton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457695330 PECOS PAC ID: 6204081995 Enrollment ID: I20130304000011 |
| Provider Name | Deborah A Baumann |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1740521210 PECOS PAC ID: 6406097286 Enrollment ID: I20130719000483 |
| Provider Name | Maura B Gerdes |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1043593841 PECOS PAC ID: 3173767076 Enrollment ID: I20130916000270 |
| Provider Name | Cassidy L Leonard-scott |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1255628335 PECOS PAC ID: 9537393889 Enrollment ID: I20140827001330 |
| Provider Name | Shelly L Collins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508275512 PECOS PAC ID: 8325268238 Enrollment ID: I20140926002164 |
| Provider Name | Cole J Scherder |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174844583 PECOS PAC ID: 8628290665 Enrollment ID: I20141107000183 |
| Provider Name | Kimberly C Shaw |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467854042 PECOS PAC ID: 7416179932 Enrollment ID: I20141117000251 |
| Provider Name | Kimberly K Cordes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750783346 PECOS PAC ID: 0345562484 Enrollment ID: I20141201001359 |
| Provider Name | Kevin T Palka |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1689721482 PECOS PAC ID: 9931177722 Enrollment ID: I20150710002183 |
| Provider Name | Lacosta K Gaines |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003287848 PECOS PAC ID: 5496055428 Enrollment ID: I20151124001344 |
| Provider Name | Stephanie L Robinson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891169256 PECOS PAC ID: 5395048896 Enrollment ID: I20160115001478 |
| Provider Name | Torishia N Greving |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124492491 PECOS PAC ID: 4587967682 Enrollment ID: I20160125000118 |
| Provider Name | Hossein Behniaye |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356533863 PECOS PAC ID: 2668652090 Enrollment ID: I20160511001264 |
| Provider Name | Hassan Behniay |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659537272 PECOS PAC ID: 4385770957 Enrollment ID: I20160525002740 |
| Provider Name | David J Lemons |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1932338753 PECOS PAC ID: 7113212275 Enrollment ID: I20160829001018 |
| Provider Name | Brooke Schreckhise |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114478252 PECOS PAC ID: 3173804101 Enrollment ID: I20170104002239 |
| Provider Name | Melissa L Reynolds |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033572938 PECOS PAC ID: 7618275744 Enrollment ID: I20170314000151 |
| Provider Name | Austin G Hake |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1003077389 PECOS PAC ID: 5890946065 Enrollment ID: I20170622000488 |
| Provider Name | Julia M Roberts |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1457767113 PECOS PAC ID: 5890016265 Enrollment ID: I20170630001595 |
| Provider Name | Amanda J Stephens |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1508177593 PECOS PAC ID: 8820224165 Enrollment ID: I20170725002308 |
| Provider Name | Kimm C Long |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1790137651 PECOS PAC ID: 1951672666 Enrollment ID: I20170728002720 |
| Provider Name | Amy M Linss |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568709228 PECOS PAC ID: 5991078628 Enrollment ID: I20170831002066 |
| Provider Name | Carolyn Ann Blackburn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902336431 PECOS PAC ID: 6709151988 Enrollment ID: I20171016000251 |
| Provider Name | Gale M Schlogl |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972012193 PECOS PAC ID: 6305104449 Enrollment ID: I20171220000154 |
| Provider Name | Stacey Copeland |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1861590770 PECOS PAC ID: 9537333877 Enrollment ID: I20180117000648 |
| Provider Name | Courtney R Nichols |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235645151 PECOS PAC ID: 7315206455 Enrollment ID: I20180117000929 |
| Provider Name | David Vincent Spencer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154820157 PECOS PAC ID: 1052673472 Enrollment ID: I20180724002212 |
| Provider Name | James Edwin Tucker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851772289 PECOS PAC ID: 9335451954 Enrollment ID: I20180803002064 |
| Provider Name | Marlee A Keele |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013400357 PECOS PAC ID: 5092065029 Enrollment ID: I20180912001149 |
| Provider Name | Caitlin A Petry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205303948 PECOS PAC ID: 0143564005 Enrollment ID: I20181203003460 |
| Provider Name | Lillian J Bruner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922570142 PECOS PAC ID: 4880932482 Enrollment ID: I20190206001137 |
| Provider Name | Tiffany A Ritter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285299719 PECOS PAC ID: 5294060190 Enrollment ID: I20190715003223 |
| Provider Name | Megan E Kretz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003471863 PECOS PAC ID: 8224364229 Enrollment ID: I20190730000237 |
| Provider Name | Jennifer E Roberts-merriman |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1740669142 PECOS PAC ID: 3173833167 Enrollment ID: I20190821000703 |
| Provider Name | Aurora C Bell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598116196 PECOS PAC ID: 5991097594 Enrollment ID: I20190826002994 |
| Provider Name | Tristin E Neumann |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669933479 PECOS PAC ID: 9335571249 Enrollment ID: I20191114002682 |
| Provider Name | Heather A Curtis |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1609244193 PECOS PAC ID: 5496188856 Enrollment ID: I20191126001053 |
| Provider Name | Brooke A Sprague |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063053650 PECOS PAC ID: 2860829348 Enrollment ID: I20200221001786 |
| Provider Name | Ann M Bibbs |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174162390 PECOS PAC ID: 9032546510 Enrollment ID: I20200221001819 |
| Provider Name | Katie L Sternberg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942859434 PECOS PAC ID: 8022446657 Enrollment ID: I20200313002082 |
| Provider Name | Mujeeb Ur-rahman Siddiqui |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1619974797 PECOS PAC ID: 3476528936 Enrollment ID: I20200329000038 |
| Provider Name | Kendell B Farr |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518593375 PECOS PAC ID: 8921438540 Enrollment ID: I20200423000275 |
| Provider Name | Douglas N Sullivant |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1467425603 PECOS PAC ID: 9436115839 Enrollment ID: I20200514002257 |
| Provider Name | Daniel K Kimple |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1699030551 PECOS PAC ID: 8224330956 Enrollment ID: I20200519002948 |
| Provider Name | Jordan A Palmer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245760495 PECOS PAC ID: 8527318484 Enrollment ID: I20200716000866 |
| Provider Name | Brandon R Jeffries |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952919656 PECOS PAC ID: 2264857242 Enrollment ID: I20200807001687 |
| Provider Name | Francis J Podbielski |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1740278217 PECOS PAC ID: 5991791923 Enrollment ID: I20201221002671 |
| Provider Name | Gail Calvert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922690254 PECOS PAC ID: 1557778255 Enrollment ID: I20210324003263 |
| Provider Name | Eric N Butler |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1346699386 PECOS PAC ID: 7810397783 Enrollment ID: I20210615000158 |
| Provider Name | Santhosh R Mannem |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1518242957 PECOS PAC ID: 6103041264 Enrollment ID: I20210616001242 |
| Provider Name | Kathryn Tripp |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710381835 PECOS PAC ID: 0648492173 Enrollment ID: I20210617001978 |
| Provider Name | Sarah Elizabeth Ernst |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588233167 PECOS PAC ID: 2365843703 Enrollment ID: I20210623002029 |
| Provider Name | Ashley Marie Lanpher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245828714 PECOS PAC ID: 5597167502 Enrollment ID: I20210714000512 |
| Provider Name | Segun Oladipo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245727684 PECOS PAC ID: 4385047877 Enrollment ID: I20210721001922 |
| Provider Name | Emma Lee Wright |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1669968467 PECOS PAC ID: 9436401833 Enrollment ID: I20210721002434 |
| Provider Name | Elliott Levi Strube |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1770902397 PECOS PAC ID: 2163729351 Enrollment ID: I20210722001091 |
| Provider Name | Jennifer Nicole Bowler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013441013 PECOS PAC ID: 3476956533 Enrollment ID: I20210727001689 |
| Provider Name | Mohammed Memon |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1164577102 PECOS PAC ID: 9436104619 Enrollment ID: I20210805003497 |
| Provider Name | Jessicaann Zandra Tuia |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457847139 PECOS PAC ID: 6103220231 Enrollment ID: I20210811001220 |
| Provider Name | Ihtesham Aatif Qureshi |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1275989543 PECOS PAC ID: 4284032715 Enrollment ID: I20211013001739 |
| Provider Name | Richie Gopal Goriparthi |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1770966053 PECOS PAC ID: 3173819224 Enrollment ID: I20211015001370 |
| Provider Name | Priyanka Yerragorla |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780068437 PECOS PAC ID: 7012263502 Enrollment ID: I20211015002575 |
| Provider Name | Jean Ricci Goodman |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1447228093 PECOS PAC ID: 4385675669 Enrollment ID: I20211122001654 |
| Provider Name | Viacheslav Iremashvili |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1407115876 PECOS PAC ID: 2062781362 Enrollment ID: I20220120001133 |
| Provider Name | Alicia Larae Lake |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891449625 PECOS PAC ID: 0941693832 Enrollment ID: I20220217002019 |
| Provider Name | Corinna Jo Sheppard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770235517 PECOS PAC ID: 2961897202 Enrollment ID: I20220323000744 |
| Provider Name | Brandon C.w. Brown |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225398019 PECOS PAC ID: 2567776206 Enrollment ID: I20220419001869 |
| Provider Name | Debra A Guinn |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1386627974 PECOS PAC ID: 4486634672 Enrollment ID: I20220427000385 |
| Provider Name | Andrew Bennett Wright |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306462775 PECOS PAC ID: 4587087465 Enrollment ID: I20220718001839 |
| Provider Name | Jaryn Black |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699392415 PECOS PAC ID: 9537586532 Enrollment ID: I20220808001045 |
| Provider Name | Sarah Marie Points |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598409435 PECOS PAC ID: 4082097100 Enrollment ID: I20220822002613 |
| Provider Name | Jennifer Lynn Minoff |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1013367101 PECOS PAC ID: 0446542310 Enrollment ID: I20220831002710 |
| Provider Name | Ma'en Nayef Al-dabbas |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1487032421 PECOS PAC ID: 6204211212 Enrollment ID: I20220912002333 |
| Provider Name | Amber D Singer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013632835 PECOS PAC ID: 5395113773 Enrollment ID: I20221115002993 |
| Provider Name | Sheila Jean Oliver |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649991803 PECOS PAC ID: 6103294491 Enrollment ID: I20221117000768 |
| Provider Name | Sarah Penn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538884978 PECOS PAC ID: 9335531060 Enrollment ID: I20221210000100 |
| Provider Name | Briana Lashaun Adams, |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669172698 PECOS PAC ID: 9830563568 Enrollment ID: I20230321001545 |
| Provider Name | Kristy Marie Taylor |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1922775659 PECOS PAC ID: 3971977133 Enrollment ID: I20230330000639 |
| 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 | Jill Marie Clark |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1134834450 PECOS PAC ID: 6608241658 Enrollment ID: I20230405001901 |
| Provider Name | Whitney Jean Roller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083315741 PECOS PAC ID: 4880059666 Enrollment ID: I20230501000826 |
| Provider Name | Jose E Torres |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1437368404 PECOS PAC ID: 7113043621 Enrollment ID: I20230602002347 |
| Provider Name | Santhisri Kodali |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114210390 PECOS PAC ID: 3375976517 Enrollment ID: I20230720003157 |
| Provider Name | Allyson Lynn Munch |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528682630 PECOS PAC ID: 2062834849 Enrollment ID: I20230926002408 |
| Provider Name | Jessica Nichole Mickels |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164066023 PECOS PAC ID: 1153778261 Enrollment ID: I20231111000397 |
| Provider Name | Karol Rosner |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053425884 PECOS PAC ID: 3476502055 Enrollment ID: I20231115002938 |
| Provider Name | Trey Allen Vuichard |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1477324663 PECOS PAC ID: 0941644033 Enrollment ID: I20240216001338 |
| Provider Name | Kristin Nicole Henke |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1396997359 PECOS PAC ID: 4486090073 Enrollment ID: I20240305004381 |
| Provider Name | Morgan Antonette Gaeke |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1669018321 PECOS PAC ID: 0143666412 Enrollment ID: I20240308001016 |
Hannibal Regional Hospital Physicians Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 6000 Hospital Drive, Hannibal, MO 63401 Phone: 573-248-1300 Fax: 573-248-5448 | |
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 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 |