| Hometown Clinic At West Plains, Llc | |
|
1402 N Kentucky Ave West Plains MO 65775-1822 | |
| (417) 256-3717 | |
| Not Available |
| Full Name | Hometown Clinic At West Plains, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1402 N Kentucky Ave, West Plains, Missouri |
| Authorized Official Name and Position | Karman Nesbitt (DIRECTOR, PRIMARY CARE CLINICS) |
| Authorized Official Contact | 8702693455 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Hometown Clinic At West Plains, Llc Po Box 986 West Plains MO 65775-0986 Ph: () - | Hometown Clinic At West Plains, Llc 1402 N Kentucky Ave West Plains MO 65775-1822 Ph: (417) 256-3717 |
| NPI Number | 1124513874 |
|---|---|
| Provider Enumeration Date | 06/26/2018 |
| Last Update Date | 05/05/2021 |
| Medicare PECOS PAC ID | 0941507677 |
|---|---|
| Medicare Enrollment ID | O20190107000951 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124513874 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | James E Thompson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598732315 PECOS PAC ID: 2163327552 Enrollment ID: I20031126000499 |
| Provider Name | Lesa Kerley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194121624 PECOS PAC ID: 8820313927 Enrollment ID: I20190109001671 |
| Provider Name | Jamie L Parrott |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1164979605 PECOS PAC ID: 3274811831 Enrollment ID: I20190815001819 |
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