| Missouri Baptist Hospital Of Sullivan | |
|
751 Sappington Bridge Rd Sullivan MO 63080-2354 | |
| (573) 468-4186 | |
| (314) 996-3610 |
| Full Name | Missouri Baptist Hospital Of Sullivan |
|---|---|
| Speciality | Hospitalist |
| Location | 751 Sappington Bridge Rd, Sullivan, Missouri |
| Authorized Official Name and Position | Tony L Schwarm (PRESIDENT) |
| Authorized Official Contact | 5734684186 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Missouri Baptist Hospital Of Sullivan 751 Sappington Bridge Rd Sullivan MO 63080-2354 Ph: (573) 468-1343 | Missouri Baptist Hospital Of Sullivan 751 Sappington Bridge Rd Sullivan MO 63080-2354 Ph: (573) 468-4186 |
| NPI Number | 1215945480 |
|---|---|
| Provider Enumeration Date | 08/04/2006 |
| Last Update Date | 07/21/2022 |
| Medicare PECOS PAC ID | 2668380148 |
|---|---|
| Medicare Enrollment ID | O20060504000053 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215945480 | NPI | - | NPPES |
| 108 | Other | BLUE CROSS-BLUE SHIELD | |
| 540565009 | Medicaid | MO | |
| 800565004 | Medicaid | MO | |
| MI010565000 | Medicaid | MO | |
| 108 | Other | BLUE CHOICE | |
| 260115 | Other | PREMIER PLUS | |
| 489665 | Other | AETNA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| 363L00000X | Nurse Practitioner | (* (Not Available)) | Secondary |
| 208M00000X | Hospitalist | (* (Not Available)) | Primary |
| Provider Name | Frances E Fister |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1760593339 PECOS PAC ID: 4183528979 Enrollment ID: I20031124000105 |
| Provider Name | Anthony Shephard |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1467431205 PECOS PAC ID: 7719081546 Enrollment ID: I20070403000457 |
| Provider Name | Jeffrey J Colench |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1568432490 PECOS PAC ID: 1153425962 Enrollment ID: I20070404000372 |
| Provider Name | Nicholas B Girdner |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1871636332 PECOS PAC ID: 1759486087 Enrollment ID: I20070416000455 |
| Provider Name | Felipe A Eljaiek |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1003927773 PECOS PAC ID: 3173616778 Enrollment ID: I20070912000095 |
| Provider Name | Jose R Remo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1598876450 PECOS PAC ID: 3072607779 Enrollment ID: I20070925000328 |
| Provider Name | Nicholas J Lyons |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1164472205 PECOS PAC ID: 4385739895 Enrollment ID: I20070928000203 |
| Provider Name | Thomas J Jackson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1528262698 PECOS PAC ID: 2466599105 Enrollment ID: I20091028000559 |
| Provider Name | Lawrence W Fournier |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1750670121 PECOS PAC ID: 4385812239 Enrollment ID: I20110719000754 |
| Provider Name | Jodi K Neill |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1922374487 PECOS PAC ID: 0648429977 Enrollment ID: I20121002000574 |
| Provider Name | Diana Busjra Brown |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1487033114 PECOS PAC ID: 1759690894 Enrollment ID: I20151012001962 |
Missouri Baptist Hospital Of Sullivan Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 965 Mattox Dr, Sullivan, MO 63080 Phone: 573-486-4186 Fax: 314-996-3610 | |
Mercy Clinic East Communities Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1326 S Service Rd W Ste 20, Sullivan, MO 63080 Phone: 573-468-3555 | |
Premier Health Center, L.l.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 102 Progress Pkwy, Sullivan, MO 63080 Phone: 573-468-6011 Fax: 573-468-7868 | |
Patients First Health Care Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 101 Progress Pkwy, Sullivan, MO 63080 Phone: 573-468-3555 Fax: 573-468-3554 | |
Patients First Health Care Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 450 Cumberland Way Ste A, Sullivan, MO 63080 Phone: 573-468-2006 Fax: 573-468-2026 | |
Compass Health, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 101 Progress Pkwy, Sullivan, MO 63080 Phone: 660-890-8186 |