| Internal Medicine at Winghaven, LLC | |
|
5551 Winghaven Blvd Ste 290 O Fallon MO 63368-3629 | |
| (636) 695-2575 | |
| (314) 590-5938 |
| Full Name | Internal Medicine at Winghaven, LLC |
|---|---|
| Speciality | Internal Medicine |
| Location | 5551 Winghaven Blvd Ste 290, O Fallon, Missouri |
| Authorized Official Name and Position | Darren Haskell (CHIEF MEDICAL OFFICER) |
| Authorized Official Contact | 3142056444 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Internal Medicine at Winghaven, LLC 121 Saint Lukes Center Dr Ste 200 Chesterfield MO 63017-3518 Ph: (636) 685-7804 | Internal Medicine at Winghaven, LLC 5551 Winghaven Blvd Ste 290 O Fallon MO 63368-3629 Ph: (636) 695-2575 |
| NPI Number | 1487924288 |
|---|---|
| Provider Enumeration Date | 01/10/2012 |
| Last Update Date | 03/05/2026 |
| Certification Date | 03/05/2026 |
| Medicare PECOS PAC ID | 6406018605 |
|---|---|
| Medicare Enrollment ID | O20120504000377 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487924288 | NPI | - | NPPES |
| 1487924288 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | () | Primary |
| Provider Name | Gary D Gray |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497729826 PECOS PAC ID: 5294832390 Enrollment ID: I20070524000580 |
| Provider Name | Gina M Schnurbusch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861928244 PECOS PAC ID: 7315215902 Enrollment ID: I20170623000361 |
| Provider Name | Amaad Bashir Rana |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1366962417 PECOS PAC ID: 2567894405 Enrollment ID: I20200722002536 |
Digestive Consultants LLC Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 5551 Winghaven Blvd Ste 250, O Fallon, MO 63368 Phone: 636-685-7795 Fax: 314-590-5959 |
Kevin L. Threlkeld, M.D., LLC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 204 N Main St, O Fallon, MO 63366 Phone: 636-240-3420 |
Internal Medicine at Winghaven LLC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5551 Winghaven Blvd Ste 290, O Fallon, MO 63368 Phone: 636-695-2575 Fax: 314-590-5938 |
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