| Malden Family Clinic and Diagnostic | |
|
1207 N Douglass St Malden MO 63863-1351 | |
| (573) 276-3884 | |
| (573) 276-3885 |
| Full Name | Malden Family Clinic and Diagnostic |
|---|---|
| Speciality | Clinic/Center |
| Location | 1207 N Douglass St, Malden, Missouri |
| Authorized Official Name and Position | Timothy William Mcpherson (OWNER) |
| Authorized Official Contact | 5736952181 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Malden Family Clinic and Diagnostic Po Box 12545 Belfast ME 04915-4016 Ph: (573) 276-3884 | Malden Family Clinic and Diagnostic 1207 N Douglass St Malden MO 63863-1351 Ph: (573) 276-3884 |
| NPI Number | 1003407883 |
|---|---|
| Provider Enumeration Date | 02/03/2021 |
| Last Update Date | 02/03/2021 |
| Certification Date | 02/03/2021 |
| Medicare PECOS PAC ID | 5698773539 |
|---|---|
| Medicare Enrollment ID | O20061201000167 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003407883 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | () | Primary |
| Provider Name | Margaret C Hart |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104853050 PECOS PAC ID: 6406847367 Enrollment ID: I20040519001386 |
| Provider Name | Roger a Sacry |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528009529 PECOS PAC ID: 9739164021 Enrollment ID: I20040621001718 |
| Provider Name | Timothy Mcpherson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245264696 PECOS PAC ID: 8123927308 Enrollment ID: I20040715000001 |
| Provider Name | Jonathan L Manzer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407848971 PECOS PAC ID: 5799765178 Enrollment ID: I20040726000227 |
| Provider Name | Shawn K Brunk |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558303404 PECOS PAC ID: 6406820547 Enrollment ID: I20040907000090 |
| Provider Name | David E Hargroder |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1811039621 PECOS PAC ID: 9335117456 Enrollment ID: I20040917000016 |
| Provider Name | Naser M Almasalmeh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1184698243 PECOS PAC ID: 4183655715 Enrollment ID: I20050824000146 |
| Provider Name | Suzanne E Alt |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811995566 PECOS PAC ID: 9931124781 Enrollment ID: I20051012000193 |
| Provider Name | Katherine G Ervie |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1740230077 PECOS PAC ID: 8628170453 Enrollment ID: I20070226000684 |
| Provider Name | Babatunde Oladiran |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1972610905 PECOS PAC ID: 5092818963 Enrollment ID: I20070314000018 |
| Provider Name | David a Abbott |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568448850 PECOS PAC ID: 6305940172 Enrollment ID: I20070404000243 |
| Provider Name | Charles Sutherland |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619945300 PECOS PAC ID: 0244336956 Enrollment ID: I20070426000037 |
| Provider Name | James L Deline |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821091810 PECOS PAC ID: 9537266820 Enrollment ID: I20070522000133 |
| Provider Name | Akinrinola Fatoki |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346354693 PECOS PAC ID: 2062309230 Enrollment ID: I20070731000158 |
| Provider Name | Abdullah Arshad |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1477660637 PECOS PAC ID: 6204928328 Enrollment ID: I20070822000142 |
| Provider Name | Emily J Garrett-pruett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952503690 PECOS PAC ID: 1254426836 Enrollment ID: I20070927000679 |
| Provider Name | Michele L Callahan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609839430 PECOS PAC ID: 8022025238 Enrollment ID: I20071218000178 |
| Provider Name | Michael Snyder |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1932239142 PECOS PAC ID: 7719084896 Enrollment ID: I20080114000622 |
| Provider Name | Gretchen E Fink |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902012719 PECOS PAC ID: 7911075825 Enrollment ID: I20081006000238 |
| Provider Name | Raj M Sajid |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265529630 PECOS PAC ID: 0648356923 Enrollment ID: I20081210000149 |
| Provider Name | James D Lawrenzi |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1174550313 PECOS PAC ID: 0941357669 Enrollment ID: I20090416000097 |
| Provider Name | Richard F Wittock |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1215943105 PECOS PAC ID: 6800849597 Enrollment ID: I20090519000219 |
| Provider Name | Frank J Villamayor |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1144479254 PECOS PAC ID: 5193862639 Enrollment ID: I20091102000350 |
| Provider Name | Donet Christopher Main |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1861409625 PECOS PAC ID: 9931105079 Enrollment ID: I20100305000505 |
| Provider Name | Robert D Tague |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588740369 PECOS PAC ID: 7719870922 Enrollment ID: I20100611000035 |
| Provider Name | Lynda G Carlyle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831412147 PECOS PAC ID: 9638200553 Enrollment ID: I20100621000818 |
| Provider Name | James R Probst |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1538270624 PECOS PAC ID: 7416965181 Enrollment ID: I20100817000180 |
| Provider Name | Carlos A. Salgueiro |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1407914039 PECOS PAC ID: 7416082912 Enrollment ID: I20110110000488 |
| Provider Name | Daniel Rivera |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1154465326 PECOS PAC ID: 7911187638 Enrollment ID: I20110211000460 |
| Provider Name | Joseph Hazan |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1881786960 PECOS PAC ID: 2567630890 Enrollment ID: I20110712000752 |
| Provider Name | Richard C Muckerman |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1649219569 PECOS PAC ID: 8325934490 Enrollment ID: I20111123000027 |
| Provider Name | Joseph K Essmyer |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1598841876 PECOS PAC ID: 6406015338 Enrollment ID: I20120312000697 |
| Provider Name | Connie L Gurley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104115153 PECOS PAC ID: 8820243249 Enrollment ID: I20130308000301 |
| Provider Name | Kristin D Wagner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205105624 PECOS PAC ID: 3577721786 Enrollment ID: I20130716000621 |
| Provider Name | Karen I Graham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982983771 PECOS PAC ID: 4385872373 Enrollment ID: I20140121001463 |
| Provider Name | Tiffany Leeker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669562591 PECOS PAC ID: 4587703673 Enrollment ID: I20150218000236 |
| Provider Name | Melinda Auer |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1326336314 PECOS PAC ID: 1456665249 Enrollment ID: I20150807013451 |
| Provider Name | Uzma Nosheen |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1568699452 PECOS PAC ID: 3072818608 Enrollment ID: I20160219001012 |
| Provider Name | Laura J Langdon |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1700269875 PECOS PAC ID: 6305153875 Enrollment ID: I20160418002164 |
| Provider Name | Sara Koenemann |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780046250 PECOS PAC ID: 8022317957 Enrollment ID: I20160428000007 |
| Provider Name | Crystal J Dyer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053861609 PECOS PAC ID: 3476832189 Enrollment ID: I20161122000054 |
| Provider Name | Bonnie Reid |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982141933 PECOS PAC ID: 7214910165 Enrollment ID: I20170418000701 |
| Provider Name | Tiffany Nelson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225565948 PECOS PAC ID: 2961777024 Enrollment ID: I20170929001116 |
| Provider Name | Babafemi Babawande Pratt |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1174773873 PECOS PAC ID: 2365695509 Enrollment ID: I20171006001374 |
| Provider Name | Lea-ana R Hodges |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831632165 PECOS PAC ID: 8921365743 Enrollment ID: I20171207002181 |
| Provider Name | Jeremy Hughes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699200477 PECOS PAC ID: 7618236118 Enrollment ID: I20180108002607 |
| Provider Name | Rachelle D Chiarottino |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104329283 PECOS PAC ID: 9032472220 Enrollment ID: I20180423001367 |
| Provider Name | Mohsin T Alhaddad |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1467624619 PECOS PAC ID: 6406036201 Enrollment ID: I20180831002262 |
| Provider Name | Kerri R Lynch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013493865 PECOS PAC ID: 7416207337 Enrollment ID: I20180913001604 |
| Provider Name | Beth E Mettes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487132056 PECOS PAC ID: 7719230549 Enrollment ID: I20181025000384 |
| Provider Name | Molly T Uribe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760980866 PECOS PAC ID: 1052674298 Enrollment ID: I20181121001716 |
| Provider Name | Ajay K Suman |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1295761542 PECOS PAC ID: 7012100357 Enrollment ID: I20181206000050 |
| Provider Name | Kourtney Halford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114407525 PECOS PAC ID: 2860738549 Enrollment ID: I20190117000753 |
| Provider Name | Candace Marie Kirkpatrick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437680394 PECOS PAC ID: 4183991250 Enrollment ID: I20190417002583 |
| Provider Name | Amy O Puderbaugh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1174878409 PECOS PAC ID: 9931420551 Enrollment ID: I20190722001455 |
| Provider Name | Laurell a Conder |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255992897 PECOS PAC ID: 1759612260 Enrollment ID: I20191025001820 |
| Provider Name | Tabitha Chu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720629561 PECOS PAC ID: 7012349475 Enrollment ID: I20191123000067 |
| Provider Name | Faaiza Arshad |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1144887001 PECOS PAC ID: 6305279589 Enrollment ID: I20191202000591 |
| Provider Name | Jody M Pryor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629602024 PECOS PAC ID: 8123459112 Enrollment ID: I20200506002997 |
| Provider Name | Adrianne Nicole Simpson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255953907 PECOS PAC ID: 9537584966 Enrollment ID: I20200803001186 |
| Provider Name | Evan G Mason |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1699195701 PECOS PAC ID: 5991092884 Enrollment ID: I20200812000819 |
| Provider Name | Manirul H Tamal |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932638129 PECOS PAC ID: 9436577368 Enrollment ID: I20200909002652 |
| Provider Name | Katherine E Laytham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750995759 PECOS PAC ID: 0941611818 Enrollment ID: I20201125000341 |
| Provider Name | Muhammad Shah Miran |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235661513 PECOS PAC ID: 9436551512 Enrollment ID: I20210712003748 |
| Provider Name | Melanie a Henry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952774275 PECOS PAC ID: 0840597852 Enrollment ID: I20210720002251 |
| Provider Name | Mary Hannah Pierce |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518565357 PECOS PAC ID: 1153724141 Enrollment ID: I20210728003181 |
| Provider Name | Kayla Fuller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033790159 PECOS PAC ID: 6305241100 Enrollment ID: I20210817002045 |
| Provider Name | Bankole Bidemi Aluko |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851983910 PECOS PAC ID: 8224435474 Enrollment ID: I20210930001878 |
| Provider Name | Susan Zhou |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952974172 PECOS PAC ID: 2860883956 Enrollment ID: I20211228002385 |
| Provider Name | Tamara K Scott |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508412446 PECOS PAC ID: 3375979065 Enrollment ID: I20220314001509 |
| Provider Name | Jordan Brotz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104574334 PECOS PAC ID: 8325434491 Enrollment ID: I20220330000987 |
| Provider Name | Thomas J Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417566142 PECOS PAC ID: 9234525841 Enrollment ID: I20220407001897 |
| Provider Name | April M Amelunke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871260174 PECOS PAC ID: 8224415146 Enrollment ID: I20220516001356 |
| Provider Name | Shelby Elizabeth Likes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710560628 PECOS PAC ID: 1254718174 Enrollment ID: I20220516001672 |
| Provider Name | Aubri D Ashbacher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528677200 PECOS PAC ID: 1557743036 Enrollment ID: I20220729002779 |
| Provider Name | Jonathan Wesley Tolman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992238513 PECOS PAC ID: 4082098173 Enrollment ID: I20220909000523 |
| Provider Name | Kristina Lynn Wadley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124741715 PECOS PAC ID: 9638555493 Enrollment ID: I20220930001530 |
| Provider Name | Leslie Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235866039 PECOS PAC ID: 3072989565 Enrollment ID: I20221025002725 |
| Provider Name | Danielle Darlene Kennedy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063118404 PECOS PAC ID: 8325410301 Enrollment ID: I20230221002254 |
| Provider Name | Stephanie Clark |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851795595 PECOS PAC ID: 2567828346 Enrollment ID: I20230522000246 |
| Provider Name | Shahzad Shah |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1356528442 PECOS PAC ID: 0143386086 Enrollment ID: I20230906000209 |
| Provider Name | Mckenzie Elizabeth Turner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962280750 PECOS PAC ID: 3678927548 Enrollment ID: I20230926003014 |
| Provider Name | Emma Kathryn Wagner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851074959 PECOS PAC ID: 7618321480 Enrollment ID: I20230927002602 |
| Provider Name | Carolyn Jean Herbert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386315778 PECOS PAC ID: 0648642363 Enrollment ID: I20230929001791 |
| Provider Name | Shellee Flora |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871276667 PECOS PAC ID: 9335593821 Enrollment ID: I20231003000773 |
| Provider Name | Faviola Marin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598136350 PECOS PAC ID: 4486000106 Enrollment ID: I20231031003364 |
| Provider Name | Katherine E Joseph |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902343247 PECOS PAC ID: 7618250002 Enrollment ID: I20231108001013 |
| Provider Name | Richard Amesquita |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1326254616 PECOS PAC ID: 5698759397 Enrollment ID: I20231108002788 |
| Provider Name | Lori E Parker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801224407 PECOS PAC ID: 3375990344 Enrollment ID: I20231113002435 |
| Provider Name | Megan Wood |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1407052996 PECOS PAC ID: 0244495521 Enrollment ID: I20231115003607 |
| Provider Name | Catherine Mepukori |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003514563 PECOS PAC ID: 1355798125 Enrollment ID: I20231116000167 |
| Provider Name | Emily Harris |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1962974741 PECOS PAC ID: 5991043762 Enrollment ID: I20231227001008 |
| Provider Name | Anna Lee Rebekah Montague |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336829035 PECOS PAC ID: 1153772173 Enrollment ID: I20240103004508 |
| Provider Name | Jennifer Greene |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477162188 PECOS PAC ID: 0547646762 Enrollment ID: I20240223001670 |
| Provider Name | Sophia Mazhou |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801657853 PECOS PAC ID: 1658717061 Enrollment ID: I20240307002972 |
| Provider Name | Chika Ijioma |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770350811 PECOS PAC ID: 1850738931 Enrollment ID: I20240325002894 |
| Provider Name | Emmanuelson N Chukwuyem |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275396376 PECOS PAC ID: 9638517071 Enrollment ID: I20240404002839 |
| Provider Name | Elaine G Childs |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1205915576 PECOS PAC ID: 7315385580 Enrollment ID: I20240406000395 |
| Provider Name | Andrea Lauren Tripoli |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417731365 PECOS PAC ID: 6507303096 Enrollment ID: I20240801002620 |
| Provider Name | Natalee Quinn Norwood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871343103 PECOS PAC ID: 3375074362 Enrollment ID: I20241001003233 |
| Provider Name | Sarah Anne Brooks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871274654 PECOS PAC ID: 9739611393 Enrollment ID: I20241021002277 |
| Provider Name | Courtney Johnston |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356176549 PECOS PAC ID: 8628502754 Enrollment ID: I20241113000377 |
| Provider Name | Patrice Wanetta Dumas Veraguth |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992900492 PECOS PAC ID: 4981143369 Enrollment ID: I20250626004065 |
| Provider Name | Scott Joseph Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578458907 PECOS PAC ID: 6709390594 Enrollment ID: I20250703002162 |
| Provider Name | James Allen Edgington |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497497432 PECOS PAC ID: 6507244258 Enrollment ID: I20250714002362 |
| Provider Name | Suzanne Steele |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205712262 PECOS PAC ID: 4183532922 Enrollment ID: I20250826004217 |
| Provider Name | Abibatou Salami |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164393872 PECOS PAC ID: 4880181619 Enrollment ID: I20251015002865 |
| Provider Name | Candace Sipes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013883297 PECOS PAC ID: 4284123886 Enrollment ID: I20251031003725 |
| Provider Name | Crystal Gail Jackson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104786185 PECOS PAC ID: 4688166960 Enrollment ID: I20251124003511 |
| Provider Name | Hannah Gleason |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851251078 PECOS PAC ID: 9537647748 Enrollment ID: I20260129002567 |
| Provider Name | Rebecca Hamlin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598615312 PECOS PAC ID: 1355821141 Enrollment ID: I20260219002456 |
| Provider Name | Brooke Lyn Mcculley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841149796 PECOS PAC ID: 3678055910 Enrollment ID: I20260305000965 |
| Provider Name | Melissa Marino |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174358568 PECOS PAC ID: 3274024344 Enrollment ID: I20260330002903 |
| Provider Name | Tejal Patel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518621606 PECOS PAC ID: 8628463270 Enrollment ID: I20260402003783 |
| Provider Name | Heather Key |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780099598 PECOS PAC ID: 5193947042 Enrollment ID: I20260518001811 |
| Provider Name | Priti Giri |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033059001 PECOS PAC ID: 7416427810 Enrollment ID: I20260527002190 |
Joseph E Pehlman Family Clinic LLC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1207 N Douglass St, Malden, MO 63863 Phone: 573-276-3884 Fax: 573-276-3885 |
Mercy Hospital Stoddard Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 500 N Douglass St, Malden, MO 63863 Phone: 573-276-2221 |
Msh Malden Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1707 N Doulgas, Malden, MO 63863 Phone: 573-276-6488 |
Daeoc Family Planning Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1 Town Sq, Malden, MO 63863 Phone: 573-276-6090 Fax: 573-276-6108 |
Southeast Health on Wheels Mobile Van Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 700 N Douglass St, Malden, MO 63863 Phone: 573-748-7701 Fax: 573-748-2554 |
Malden Primary Care Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 412 W Broadwater Rd, Malden, MO 63863 Phone: 573-990-1002 Fax: 573-990-1284 |