| Missouri Mso LLC | |
|
1501 Charbonier Rd Florissant MO 63031-5308 | |
| (212) 734-6621 | |
| Not Available |
| Full Name | Missouri Mso LLC |
|---|---|
| Speciality | Family Medicine |
| Location | 1501 Charbonier Rd, Florissant, Missouri |
| Authorized Official Name and Position | Samuel Kohn (MANAGER) |
| Authorized Official Contact | 3476316775 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Missouri Mso LLC 4770 White Plains Rd Bronx NY 10470-1136 | Missouri Mso LLC 1501 Charbonier Rd Florissant MO 63031-5308 Ph: (212) 734-6621 |
| NPI Number | 1538041769 |
|---|---|
| Provider Enumeration Date | 07/21/2025 |
| Last Update Date | 01/08/2026 |
| Certification Date | 01/08/2026 |
| Medicare PECOS PAC ID | 3274035035 |
|---|---|
| Medicare Enrollment ID | O20250909002506 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538041769 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (NU) | Primary |
| Provider Name | Cheryl L Richard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275708521 PECOS PAC ID: 9739233800 Enrollment ID: I20090825000188 |
| Provider Name | Kathy A. Palen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649530825 PECOS PAC ID: 8426214198 Enrollment ID: I20120724000857 |
| Provider Name | Leah W Legrand |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851765614 PECOS PAC ID: 3375606346 Enrollment ID: I20151214001653 |
| Provider Name | Brandy Diane Divine |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457803363 PECOS PAC ID: 8527347772 Enrollment ID: I20161111000685 |
| Provider Name | Kati Danielle Hinkle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588005599 PECOS PAC ID: 9335448216 Enrollment ID: I20170308002265 |
| Provider Name | Kathryn L Ries |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275071326 PECOS PAC ID: 4486930203 Enrollment ID: I20170411000058 |
| Provider Name | Sarah Ann Sotta |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164913141 PECOS PAC ID: 9830446491 Enrollment ID: I20180727001766 |
| Provider Name | Kelcy F Sayler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942761069 PECOS PAC ID: 9436482296 Enrollment ID: I20190610002274 |
| Provider Name | Katherine Margaret King |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588218812 PECOS PAC ID: 2466789144 Enrollment ID: I20190805001606 |
| Provider Name | Danna R France |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538827175 PECOS PAC ID: 5991196529 Enrollment ID: I20211215001761 |
| Provider Name | April M Amelunke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871260174 PECOS PAC ID: 8224415146 Enrollment ID: I20220516001356 |
| Provider Name | Michelle Renee Nash |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356982896 PECOS PAC ID: 7214301415 Enrollment ID: I20230329000919 |
| Provider Name | Mary Beasley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427763424 PECOS PAC ID: 4880051721 Enrollment ID: I20230607002511 |
| Provider Name | Alayna Titus |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1780398545 PECOS PAC ID: 5294175014 Enrollment ID: I20240426002288 |
| Provider Name | Daleena Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184212128 PECOS PAC ID: 7214326347 Enrollment ID: I20250129002722 |
| Provider Name | Olivia Dawn Winschel |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1043026164 PECOS PAC ID: 6901297928 Enrollment ID: I20250410002792 |
| Provider Name | Heidi R Andress |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285438358 PECOS PAC ID: 8224556105 Enrollment ID: I20250514002726 |
| Provider Name | Regina Gonia |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356138440 PECOS PAC ID: 0244739282 Enrollment ID: I20250818001689 |
| Provider Name | Lori Calloway |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528492907 PECOS PAC ID: 3274808704 Enrollment ID: I20250910000579 |
| Provider Name | Emily Yvonne Boles Sallade |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649024902 PECOS PAC ID: 7810481439 Enrollment ID: I20251211000798 |
| Provider Name | Jennifer May |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285119651 PECOS PAC ID: 6901145606 Enrollment ID: I20260320000833 |
| Provider Name | Kevin Straszacker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538886833 PECOS PAC ID: 9739551367 Enrollment ID: I20260514001299 |
Northwest Physicians Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1225 Graham Rd, Suite 220, Florissant, MO 63031 Phone: 314-838-6700 Fax: 314-838-6020 |
Kim Lee Mcdonald, M.D., P.C. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4585 Washington St, Suite C4, Florissant, MO 63033 Phone: 314-838-8839 Fax: 314-838-4291 |
Javiish Industries LLC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1825 Dunn Rd, Florissant, MO 63033 Phone: 314-200-1233 Fax: 314-200-1484 |
Bjc Medical Group North County Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1150 Graham Rd, Suite 101, Florissant, MO 63031 Phone: 314-831-6737 Fax: 314-831-9269 |
Meda Integrative Family Medicine & Aesthetics Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 8214 N Lindbergh Blvd, Florissant, MO 63031 Phone: 314-452-3259 |
Metro Medical North County LLC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 11115 New Halls Ferry Rd Ste 105, Florissant, MO 63033 Phone: 314-921-6200 Fax: 314-830-0756 |