| Missouri Delta Medical Center | |
|
1008 N Main St Sikeston MO 63801-5044 | |
| (573) 471-1600 | |
| Not Available |
| Full Name | Missouri Delta Medical Center |
|---|---|
| Speciality | Internal Medicine |
| Location | 1008 N Main St, Sikeston, Missouri |
| Authorized Official Name and Position | Jason Schrumpf (CEO/PRESIDENT) |
| Authorized Official Contact | 5734727601 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Missouri Delta Medical Center 1008 N Main St Sikeston MO 63801-5044 Ph: (573) 471-1600 | Missouri Delta Medical Center 1008 N Main St Sikeston MO 63801-5044 Ph: (573) 471-1600 |
| NPI Number | 1508967860 |
|---|---|
| Provider Enumeration Date | 09/26/2006 |
| Last Update Date | 03/12/2015 |
| Medicare PECOS PAC ID | 1355252891 |
|---|---|
| Medicare Enrollment ID | O20040308001306 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508967860 | NPI | - | NPPES |
| 506033505 | Medicaid | MO |
| Provider Name | Jennifer Ann Nickell |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1710082433 PECOS PAC ID: 2961308754 Enrollment ID: I20031211000528 |
| Provider Name | Michael D Barnes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861481426 PECOS PAC ID: 1951209014 Enrollment ID: I20031229000061 |
| Provider Name | Bruce Bieneman |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1740200187 PECOS PAC ID: 5092600122 Enrollment ID: I20040218000389 |
| Provider Name | Bradley Baker |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1093790487 PECOS PAC ID: 8224923362 Enrollment ID: I20040218000422 |
| Provider Name | Lisa E Colwick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437248705 PECOS PAC ID: 4789573981 Enrollment ID: I20040315000646 |
| Provider Name | Jeffrey Judd |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1689659039 PECOS PAC ID: 2365434495 Enrollment ID: I20040331000270 |
| Provider Name | Amy Kellams Stinnett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972593465 PECOS PAC ID: 2163410580 Enrollment ID: I20040504001435 |
| Provider Name | Deborah K Schlick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659401933 PECOS PAC ID: 9931198199 Enrollment ID: I20040511001573 |
| Provider Name | Michael Stadnyk |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1356455463 PECOS PAC ID: 2961482302 Enrollment ID: I20040724000416 |
| Provider Name | Douglas S Fitzwater |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1619967106 PECOS PAC ID: 2365349768 Enrollment ID: I20040915000253 |
| Provider Name | Mark A Meadors |
|---|---|
| Provider Type | Practitioner - Hematology |
| Provider Identifiers | NPI Number: 1962593731 PECOS PAC ID: 1153229976 Enrollment ID: I20040927000933 |
| Provider Name | David W Stroud |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1588769293 PECOS PAC ID: 6709846827 Enrollment ID: I20041013000959 |
| Provider Name | Karen G Hyatt |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1306870951 PECOS PAC ID: 7911971700 Enrollment ID: I20041015000002 |
| Provider Name | George Katsantonis |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1184610693 PECOS PAC ID: 3870553324 Enrollment ID: I20041019000241 |
| Provider Name | William Mehard |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1548293673 PECOS PAC ID: 3375507718 Enrollment ID: I20041116000684 |
| Provider Name | Lynn N Carlton |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1922054659 PECOS PAC ID: 8426021809 Enrollment ID: I20041208000877 |
| Provider Name | Charles E Lavalle |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1477537975 PECOS PAC ID: 8325005812 Enrollment ID: I20041216000310 |
| Provider Name | Prem Sobti |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1932159993 PECOS PAC ID: 1153315411 Enrollment ID: I20050208000047 |
| Provider Name | Michael J Naughton |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1295752830 PECOS PAC ID: 9234173303 Enrollment ID: I20050620000468 |
| Provider Name | Tina Moore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851483523 PECOS PAC ID: 2264477496 Enrollment ID: I20050628000203 |
| Provider Name | Brandon Covert |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1639135437 PECOS PAC ID: 4587566914 Enrollment ID: I20050707000996 |
| Provider Name | Stanley Ziomek |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1639124647 PECOS PAC ID: 2769424522 Enrollment ID: I20050719000005 |
| Provider Name | Fred K Uthoff |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1639164965 PECOS PAC ID: 7618902586 Enrollment ID: I20050929000036 |
| Provider Name | Ly T Phan |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1356430870 PECOS PAC ID: 0547288565 Enrollment ID: I20051109000014 |
| Provider Name | Paula F Guinnip |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1023239720 PECOS PAC ID: 5395723761 Enrollment ID: I20051212000212 |
| Provider Name | Joseph H Jacob |
|---|---|
| Provider Type | Practitioner - Gynecological Oncology |
| Provider Identifiers | NPI Number: 1720030349 PECOS PAC ID: 1254352461 Enrollment ID: I20051215000627 |
| Provider Name | Pascal N Nyachowe |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1285684167 PECOS PAC ID: 8325069149 Enrollment ID: I20060405000581 |
| Provider Name | Sameer Yameen Arain |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1750305546 PECOS PAC ID: 0749284289 Enrollment ID: I20060914000173 |
| Provider Name | Sarah H Curry |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083728935 PECOS PAC ID: 2365440591 Enrollment ID: I20061121000727 |
| Provider Name | Marcia Moore |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1760554521 PECOS PAC ID: 2062409238 Enrollment ID: I20061221000190 |
| Provider Name | Angela R Menz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619081593 PECOS PAC ID: 9638273048 Enrollment ID: I20070323000491 |
| Provider Name | Wilson P Pais |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1407982200 PECOS PAC ID: 5991805400 Enrollment ID: I20070713000046 |
| Provider Name | Matthew Stadnyk |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1750313094 PECOS PAC ID: 5092806992 Enrollment ID: I20070807000516 |
| Provider Name | Muhannad F Al-kilani |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1205857216 PECOS PAC ID: 2567543663 Enrollment ID: I20080115000358 |
| Provider Name | Sherry D Welker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508941626 PECOS PAC ID: 9234210287 Enrollment ID: I20080115000759 |
| Provider Name | Colleen L Hunter |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639274236 PECOS PAC ID: 1254413669 Enrollment ID: I20080124000172 |
| Provider Name | Jane E Eaves |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598854945 PECOS PAC ID: 7810079902 Enrollment ID: I20080129000101 |
| Provider Name | Robert E Perry |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659376234 PECOS PAC ID: 2264519651 Enrollment ID: I20080409000620 |
| Provider Name | Samuel Bieligk |
|---|---|
| Provider Type | Practitioner - Surgical Oncology |
| Provider Identifiers | NPI Number: 1982618112 PECOS PAC ID: 2567423999 Enrollment ID: I20080505000127 |
| Provider Name | Michael R Freeman |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1851361455 PECOS PAC ID: 9739250010 Enrollment ID: I20080613000127 |
| Provider Name | Mowaffaq R Said |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1629173554 PECOS PAC ID: 3375611981 Enrollment ID: I20081009000540 |
| Provider Name | Syed M S Sayeed |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1619190162 PECOS PAC ID: 0840358289 Enrollment ID: I20081029000130 |
| Provider Name | David Huyette |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1295782480 PECOS PAC ID: 8022023696 Enrollment ID: I20081204000875 |
| Provider Name | Kenneth C Moy |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1639164189 PECOS PAC ID: 2961550686 Enrollment ID: I20090506000185 |
| Provider Name | Michael A Dawes |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1083831713 PECOS PAC ID: 2769529858 Enrollment ID: I20091022000022 |
| Provider Name | Andrew J Moore |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1881813202 PECOS PAC ID: 0042357147 Enrollment ID: I20091022000113 |
| Provider Name | Farrah T Mcspadden |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1205053758 PECOS PAC ID: 8921146168 Enrollment ID: I20091110000112 |
| Provider Name | Murtaza Hayat |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1669426383 PECOS PAC ID: 5496759771 Enrollment ID: I20100206000106 |
| Provider Name | Amber N Thorne |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427385376 PECOS PAC ID: 0547305229 Enrollment ID: I20100305000260 |
| Provider Name | Gregorio L Rodriguez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790883064 PECOS PAC ID: 6103961636 Enrollment ID: I20100308000724 |
| Provider Name | Marc Clemente |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1073576484 PECOS PAC ID: 7719998368 Enrollment ID: I20100320000101 |
| Provider Name | Roger Bost |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1881672418 PECOS PAC ID: 1254241037 Enrollment ID: I20100603000665 |
| Provider Name | Walter L Johnston |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215163498 PECOS PAC ID: 7214067800 Enrollment ID: I20100608000578 |
| Provider Name | Stephen B Lillard |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1285625749 PECOS PAC ID: 4284780529 Enrollment ID: I20100716000216 |
| Provider Name | Archana S Abhyankar |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1477710051 PECOS PAC ID: 5991837122 Enrollment ID: I20100722000931 |
| Provider Name | Eric George Morton |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1841292216 PECOS PAC ID: 2264513480 Enrollment ID: I20100727000884 |
| Provider Name | Linza T Killion |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1033108691 PECOS PAC ID: 8527158823 Enrollment ID: I20100824000699 |
| Provider Name | Michele L Tanz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013222983 PECOS PAC ID: 2466578463 Enrollment ID: I20100928000387 |
| Provider Name | Laurel A Campbell |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1063618932 PECOS PAC ID: 7618169343 Enrollment ID: I20101013000062 |
| Provider Name | Carrie M Decker |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1972612521 PECOS PAC ID: 9830190404 Enrollment ID: I20101015000672 |
| Provider Name | Stephen T Welton |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1922078328 PECOS PAC ID: 9234038464 Enrollment ID: I20101019001548 |
| Provider Name | Ramiro Icaza |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457463960 PECOS PAC ID: 1052505740 Enrollment ID: I20101026001419 |
| Provider Name | Lee Catherine Chesnick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891095501 PECOS PAC ID: 2769679208 Enrollment ID: I20101209000207 |
| Provider Name | Adonis De Bernardo |
|---|---|
| Provider Type | Practitioner - Preventive Medicine |
| Provider Identifiers | NPI Number: 1528247970 PECOS PAC ID: 3375726052 Enrollment ID: I20110318000365 |
| Provider Name | Husam H Najjar |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1154485381 PECOS PAC ID: 1456457589 Enrollment ID: I20110801000197 |
| Provider Name | Jeffrey D Griesemer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851551907 PECOS PAC ID: 2365627247 Enrollment ID: I20110801000227 |
| Provider Name | Karl E. Shanstrom |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689815201 PECOS PAC ID: 1951570399 Enrollment ID: I20110801000954 |
| Provider Name | Lee T Hammon |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1073745980 PECOS PAC ID: 9638215908 Enrollment ID: I20111019000896 |
| Provider Name | Sherry Chessor |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1689899635 PECOS PAC ID: 1557535960 Enrollment ID: I20111122000083 |
| Provider Name | Charlotte Dewitt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104106509 PECOS PAC ID: 2860670510 Enrollment ID: I20120112000327 |
| Provider Name | Penny D Shelton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881617116 PECOS PAC ID: 7113967977 Enrollment ID: I20120203000478 |
| Provider Name | John T Lake |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1629270194 PECOS PAC ID: 2567621196 Enrollment ID: I20120316000481 |
| Provider Name | John Stephens |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1902002744 PECOS PAC ID: 1557521937 Enrollment ID: I20120321000760 |
| Provider Name | Sean Burns |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1578756193 PECOS PAC ID: 7012171903 Enrollment ID: I20120605000379 |
| Provider Name | Raymond E Sisk |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699067645 PECOS PAC ID: 8325202252 Enrollment ID: I20120605000764 |
| Provider Name | Brenna Maria C Keller |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1932261104 PECOS PAC ID: 7113078361 Enrollment ID: I20121023000587 |
| Provider Name | Pavan N Palepu |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1851591614 PECOS PAC ID: 9436296068 Enrollment ID: I20121112000353 |
| Provider Name | Judith S Menz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538264072 PECOS PAC ID: 3971744012 Enrollment ID: I20130801000152 |
| Provider Name | Margaret L Dicus |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386733830 PECOS PAC ID: 8224279385 Enrollment ID: I20130801000330 |
| Provider Name | Mary D Stephens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962571083 PECOS PAC ID: 6901049998 Enrollment ID: I20130823000018 |
| Provider Name | Paul Montany |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1750377099 PECOS PAC ID: 9335199140 Enrollment ID: I20131115001562 |
| Provider Name | Rudy R Rodriguez |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1841436870 PECOS PAC ID: 0446487581 Enrollment ID: I20131216001131 |
| Provider Name | Ladonna Jean Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861826968 PECOS PAC ID: 9739319757 Enrollment ID: I20140312001832 |
| Provider Name | Anna Wahlig |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1245541663 PECOS PAC ID: 9830315647 Enrollment ID: I20140730001918 |
| Provider Name | Rami Alassaad |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1235449265 PECOS PAC ID: 5799903167 Enrollment ID: I20140826002419 |
| Provider Name | Susanne R Owens |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1811259955 PECOS PAC ID: 0345564613 Enrollment ID: I20150114000883 |
| Provider Name | James Timothy Urhahn |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1235492562 PECOS PAC ID: 2668437765 Enrollment ID: I20150114001428 |
| Provider Name | Courtney J Yarbrough |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942638622 PECOS PAC ID: 2961632310 Enrollment ID: I20150116001658 |
| Provider Name | Fallan Mayabb |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1437440245 PECOS PAC ID: 0648581280 Enrollment ID: I20150623001471 |
| Provider Name | Luis Arcay Montagne |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1225346802 PECOS PAC ID: 0244541761 Enrollment ID: I20150624001168 |
| Provider Name | Chase Lynn Sessions |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366702813 PECOS PAC ID: 7012238843 Enrollment ID: I20150722004190 |
| Provider Name | Saman Ibrahim |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1730451576 PECOS PAC ID: 2365607744 Enrollment ID: I20150814013913 |
| Provider Name | Elena R Lopez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831161132 PECOS PAC ID: 5698081552 Enrollment ID: I20150909000347 |
| Provider Name | Ashley Oldham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669858429 PECOS PAC ID: 9537476999 Enrollment ID: I20150916003440 |
| Provider Name | Makenna R Wright |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1285013003 PECOS PAC ID: 1850608027 Enrollment ID: I20150921001649 |
| Provider Name | Hollie Wheeler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619274933 PECOS PAC ID: 3072745892 Enrollment ID: I20151104002101 |
| Provider Name | Luke Hubbard |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1265817779 PECOS PAC ID: 9537464847 Enrollment ID: I20160224002701 |
| Provider Name | Kimberly Hagedorn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669832556 PECOS PAC ID: 1951608454 Enrollment ID: I20160329000790 |
| Provider Name | Rebecca Lenderman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841658523 PECOS PAC ID: 0244538312 Enrollment ID: I20160406001613 |
| Provider Name | Erick K Schuermann |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1558630269 PECOS PAC ID: 5294953055 Enrollment ID: I20160816000166 |
| Provider Name | Abdel-qader Al-bashabsheh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1316387319 PECOS PAC ID: 2163717851 Enrollment ID: I20160819000409 |
| Provider Name | Cyriacus Anaele |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1942456256 PECOS PAC ID: 2769541366 Enrollment ID: I20170118001413 |
| Provider Name | Nivedita Nagam |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1437461290 PECOS PAC ID: 8022242056 Enrollment ID: I20170202001528 |
| Provider Name | Briana L Thompson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083152847 PECOS PAC ID: 7416230644 Enrollment ID: I20170213001612 |
| Provider Name | Monica Drylewicz |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1023371499 PECOS PAC ID: 1456591031 Enrollment ID: I20170510000252 |
| Provider Name | Kristain D Carroll |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1063956035 PECOS PAC ID: 5799062246 Enrollment ID: I20170510001194 |
| Provider Name | Randall Lane Heller |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1326337932 PECOS PAC ID: 1456628270 Enrollment ID: I20170530000595 |
| Provider Name | Animesh Sahai |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1538258629 PECOS PAC ID: 2860468352 Enrollment ID: I20170613002399 |
| Provider Name | Madhu Sahai |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1972658979 PECOS PAC ID: 3476531443 Enrollment ID: I20170816003914 |
| Provider Name | Margaret Rachel Coppage |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053835918 PECOS PAC ID: 7719252311 Enrollment ID: I20171009000150 |
| Provider Name | James Jeremiah Mooty |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467952606 PECOS PAC ID: 9931460862 Enrollment ID: I20180309001145 |
| Provider Name | Omar Mohammad Khan |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1508832841 PECOS PAC ID: 9931276193 Enrollment ID: I20180316001201 |
| Provider Name | Kristin Presley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922501923 PECOS PAC ID: 2062774698 Enrollment ID: I20180320001630 |
| Provider Name | Christine B Ormsby |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1174788558 PECOS PAC ID: 9830339035 Enrollment ID: I20180322002230 |
| Provider Name | Tara Hux |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821572595 PECOS PAC ID: 6709130214 Enrollment ID: I20181120002145 |
| Provider Name | Alexandria M Barker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891270666 PECOS PAC ID: 5991049470 Enrollment ID: I20181211001065 |
| Provider Name | Jordan Charles Nepute |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1821438607 PECOS PAC ID: 2961704382 Enrollment ID: I20190131002103 |
| Provider Name | Rowdy J Phillips |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336612779 PECOS PAC ID: 0547508244 Enrollment ID: I20190205000200 |
| Provider Name | Grace Elizabeth Jackson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1659460814 PECOS PAC ID: 4183760945 Enrollment ID: I20190404002390 |
| Provider Name | Vanessa R Sanders |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1841600194 PECOS PAC ID: 4880936483 Enrollment ID: I20190501001420 |
| Provider Name | Brooke M Carlyle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316430440 PECOS PAC ID: 3779816186 Enrollment ID: I20190617002108 |
| Provider Name | Alicia A King |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255884359 PECOS PAC ID: 9335475573 Enrollment ID: I20190725003547 |
| Provider Name | Jami Obermann |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558890145 PECOS PAC ID: 8325374093 Enrollment ID: I20190801003342 |
| Provider Name | Enock E Faustin |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1033440631 PECOS PAC ID: 8224463435 Enrollment ID: I20200116001249 |
| Provider Name | Louis A Leskosky |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1295777563 PECOS PAC ID: 1951310218 Enrollment ID: I20200129001304 |
| Provider Name | David A Leitman |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1427378298 PECOS PAC ID: 2961750898 Enrollment ID: I20200204002511 |
| Provider Name | Heather E Jackson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699308569 PECOS PAC ID: 9335561745 Enrollment ID: I20200611002660 |
| Provider Name | Stacy D Latham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457998809 PECOS PAC ID: 4880016963 Enrollment ID: I20200618000207 |
| Provider Name | Jacob S Wren |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1154940344 PECOS PAC ID: 1658794896 Enrollment ID: I20200707002625 |
| Provider Name | Alicia Maria Henao Uribe |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1295922995 PECOS PAC ID: 3375969512 Enrollment ID: I20200818002671 |
| Provider Name | Curt Mcclellan |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1558331389 PECOS PAC ID: 0143219584 Enrollment ID: I20200827001545 |
| Provider Name | Samantha Marie Broughton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700447315 PECOS PAC ID: 9537586060 Enrollment ID: I20200831000099 |
| Provider Name | Heather Pullen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659987725 PECOS PAC ID: 3678992393 Enrollment ID: I20200930000964 |
| Provider Name | Tarek Odah |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1629599519 PECOS PAC ID: 3173942778 Enrollment ID: I20201001000575 |
| Provider Name | Enrique Villavicencio Sumire |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1386027506 PECOS PAC ID: 8426303298 Enrollment ID: I20201026002767 |
| Provider Name | Kayla Babb-dicus |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508484890 PECOS PAC ID: 8921414673 Enrollment ID: I20210304001595 |
| Provider Name | Eric N Butler |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1346699386 PECOS PAC ID: 7810397783 Enrollment ID: I20210615000158 |
| Provider Name | Allison E Sindle |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1609305713 PECOS PAC ID: 1850661307 Enrollment ID: I20210625001094 |
| Provider Name | Jessica Michelle Thompson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073196044 PECOS PAC ID: 7012310287 Enrollment ID: I20210726001708 |
| Provider Name | Alana Michele Mccoy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073186102 PECOS PAC ID: 5597168591 Enrollment ID: I20210728003290 |
| Provider Name | Brittney Joy Dirnberger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013580968 PECOS PAC ID: 0749685071 Enrollment ID: I20210824002439 |
| Provider Name | Erin Meixner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295401917 PECOS PAC ID: 4486059680 Enrollment ID: I20210826001605 |
| Provider Name | Jessica Shaw |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1043984388 PECOS PAC ID: 1254737711 Enrollment ID: I20210908002538 |
| Provider Name | Muhammad Ehtisham |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1407222433 PECOS PAC ID: 3779890629 Enrollment ID: I20211104002539 |
| Provider Name | Minni Malhotra |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528257508 PECOS PAC ID: 5698849206 Enrollment ID: I20220110001439 |
| Provider Name | Jacob Russell Randich |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1922668755 PECOS PAC ID: 3274915079 Enrollment ID: I20220726002090 |
| Provider Name | Zachary Michael Shaw |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1972269587 PECOS PAC ID: 0446633135 Enrollment ID: I20220812001113 |
| Provider Name | Michael Anthony Glastetter |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1306583760 PECOS PAC ID: 9335523612 Enrollment ID: I20220906001914 |
| Provider Name | Macey Laplant |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750037735 PECOS PAC ID: 8022484260 Enrollment ID: I20221013000947 |
| Provider Name | Juliana A Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124749775 PECOS PAC ID: 5294102430 Enrollment ID: I20221101002299 |
| Provider Name | Lauren M Schick |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1538886460 PECOS PAC ID: 6800265562 Enrollment ID: I20221220001121 |
| Provider Name | David James Gibson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1437498276 PECOS PAC ID: 3375941248 Enrollment ID: I20230111002344 |
| Provider Name | Timothy James Hoe-yan Moy |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1083318109 PECOS PAC ID: 4789049883 Enrollment ID: I20230425000694 |
| Provider Name | Brent Michael Lindsley |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1386089324 PECOS PAC ID: 9436451903 Enrollment ID: I20230525000417 |
| Provider Name | Girish Singhania |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1558660217 PECOS PAC ID: 8527297100 Enrollment ID: I20230630001557 |
| Provider Name | Lacey Rose Young |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932728300 PECOS PAC ID: 6002238490 Enrollment ID: I20230812000071 |
| Provider Name | Maradale Olivia Karafa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972283331 PECOS PAC ID: 8820451826 Enrollment ID: I20230823003379 |
| Provider Name | Natalia Rose Vandeven |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194407635 PECOS PAC ID: 4183087687 Enrollment ID: I20230831001286 |
| Provider Name | Eugene Galperin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548318330 PECOS PAC ID: 9436127776 Enrollment ID: I20231025002494 |
| Provider Name | Muhammad Tariq Shakoor |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1952656498 PECOS PAC ID: 7113153099 Enrollment ID: I20231026000932 |
| Provider Name | Ashley Rachelle Elkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629851282 PECOS PAC ID: 8123474178 Enrollment ID: I20231026002669 |
| Provider Name | Jessica Peterson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1871906107 PECOS PAC ID: 8325382732 Enrollment ID: I20231031001104 |
| Provider Name | Jonathan Hulkower |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1063597961 PECOS PAC ID: 0749323343 Enrollment ID: I20231113000829 |
| Provider Name | Muhammad R Puri |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1972850170 PECOS PAC ID: 0749591055 Enrollment ID: I20231128001218 |
| Provider Name | Nidal Badran |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1831662568 PECOS PAC ID: 5597098640 Enrollment ID: I20231222001902 |
| Provider Name | Hasan Riaz |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1780831164 PECOS PAC ID: 8426372681 Enrollment ID: I20240103003752 |
| Provider Name | Roni Sharon |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1548581275 PECOS PAC ID: 4385863877 Enrollment ID: I20240104000239 |
| Provider Name | Batool Kirmani |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1316070576 PECOS PAC ID: 0345332912 Enrollment ID: I20240108000757 |
| Provider Name | Joseph Carcione |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1528085149 PECOS PAC ID: 4688675945 Enrollment ID: I20240213001933 |
| Provider Name | Khurram Nazir |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1619261252 PECOS PAC ID: 1951615871 Enrollment ID: I20240215000879 |
| Provider Name | Prashanth Reddy |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1811420763 PECOS PAC ID: 5496148116 Enrollment ID: I20240412001103 |
| Provider Name | Christopher Dean Terrill |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1053808279 PECOS PAC ID: 9739414590 Enrollment ID: I20240509000168 |
| Provider Name | Tristan Ross Peregrino Fowler |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1881044006 PECOS PAC ID: 6305268830 Enrollment ID: I20240717002776 |
| Provider Name | Razvan Iorga |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1841853371 PECOS PAC ID: 5496081853 Enrollment ID: I20240814003567 |
| Provider Name | Aubree Lemarr |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629600499 PECOS PAC ID: 3678902194 Enrollment ID: I20240821002831 |
| Provider Name | Claire-louise Sophia Young |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447894092 PECOS PAC ID: 3870033152 Enrollment ID: I20240912004453 |
| Provider Name | Traci Ryan |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1407847650 PECOS PAC ID: 3678501269 Enrollment ID: I20241009003462 |
| Provider Name | Caleb Lawrence Pruitt |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1598429482 PECOS PAC ID: 2163954082 Enrollment ID: I20241017000335 |
| Provider Name | Aileen C Cangiano-heath |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1609074616 PECOS PAC ID: 9234544735 Enrollment ID: I20241022000199 |
| Provider Name | Donna Jean Boone-springer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306931159 PECOS PAC ID: 8426959917 Enrollment ID: I20241217003638 |
| Provider Name | Deborah Oliver |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1881007961 PECOS PAC ID: 2163950056 Enrollment ID: I20250106001582 |
| Provider Name | Linesse Maria Vega |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1114105897 PECOS PAC ID: 6002047206 Enrollment ID: I20250124001228 |
| Provider Name | Obinna Ifeanyichukwu Moneme |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1316168743 PECOS PAC ID: 0648448894 Enrollment ID: I20250211003257 |
| Provider Name | Shakthi Nandan Sureddi |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1114421336 PECOS PAC ID: 2365787173 Enrollment ID: I20250325000311 |
| Provider Name | Mary Elizabeth Menz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760115257 PECOS PAC ID: 6507381365 Enrollment ID: I20250415001548 |
| Provider Name | Teresa Mangin |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1144385352 PECOS PAC ID: 9032284104 Enrollment ID: I20250417002724 |
Missouri Delta Medical Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1013 North Main, Sikeston, MO 63801 Phone: 573-472-7535 Fax: 573-472-7787 | |
Managed Care Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 808 Hunter, Suite 4, Sikeston, MO 63801 Phone: 573-471-2905 | |
Southeast Missouri Health Network Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 200 Southland Dr, Sikeston, MO 63801 Phone: 573-472-1770 Fax: 573-472-4050 | |
Missouri Delta Medical Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 102 Hospitality Dr, Sikeston, MO 63801 Phone: 573-471-0200 Fax: 573-471-7559 | |
Missouri Delta Medical Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 123 Smith Ave, Sikeston, MO 63801 Phone: 573-471-0200 | |
Missouri Delta Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1008 N Main St, Sikeston, MO 63801 Phone: 573-471-1600 Fax: 573-472-7740 | |
Ferguson Medical Group Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1012 N Main St, Sikeston, MO 63801 Phone: 573-471-0330 Fax: 573-472-2966 |