| Pershing Memorial Hospital | |
|
130 E Lockling Ave Brookfield MO 64628-0408 | |
| (660) 258-2222 | |
| (660) 258-5668 |
| Full Name | Pershing Memorial Hospital |
|---|---|
| Speciality | Clinic/Center |
| Location | 130 E Lockling Ave, Brookfield, Missouri |
| Authorized Official Name and Position | Kenneth E Baranski (CFO) |
| Authorized Official Contact | 6602581288 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pershing Memorial Hospital 130 E Lockling Ave P.o. Box 408 Brookfield MO 64628-0408 Ph: (660) 258-2222 | Pershing Memorial Hospital 130 E Lockling Ave Brookfield MO 64628-0408 Ph: (660) 258-2222 |
| NPI Number | 1982612461 |
|---|---|
| Provider Enumeration Date | 08/03/2006 |
| Last Update Date | 11/08/2023 |
| Certification Date | 11/08/2023 |
| Medicare PECOS PAC ID | 2860306750 |
|---|---|
| Medicare Enrollment ID | O20031117000114 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982612461 | NPI | - | NPPES |
| 912858305 | Medicaid | MO | |
| 540570405 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (NU) | Primary |
| 146D00000X | Personal Emergency Response Attendant | 19843 (Missouri) | Secondary |
| Provider Name | Jerry L Wait |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316013675 PECOS PAC ID: 7315850997 Enrollment ID: I20031110000536 |
| Provider Name | Charles M Sciolaro |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1942215835 PECOS PAC ID: 9830002161 Enrollment ID: I20031111000894 |
| Provider Name | Robert Wayne Jackson |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1730293705 PECOS PAC ID: 3476448952 Enrollment ID: I20040216000667 |
| Provider Name | Reuel M Gregory |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861454910 PECOS PAC ID: 9335038637 Enrollment ID: I20040315000101 |
| Provider Name | Robert Remis |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1528047974 PECOS PAC ID: 6901888247 Enrollment ID: I20040602000338 |
| Provider Name | Danny W Bartlett |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538147046 PECOS PAC ID: 4880679075 Enrollment ID: I20040622000665 |
| Provider Name | Oge G Chukwu |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1528033859 PECOS PAC ID: 8325014780 Enrollment ID: I20040907001179 |
| Provider Name | Karen a Sylvara |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003812090 PECOS PAC ID: 7214996560 Enrollment ID: I20041012001007 |
| Provider Name | Deborah Manning |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144262999 PECOS PAC ID: 7416906409 Enrollment ID: I20050117000551 |
| Provider Name | Donald J Meyer |
|---|---|
| Provider Type | Practitioner - Interventional Pain Management |
| Provider Identifiers | NPI Number: 1912990805 PECOS PAC ID: 6507816493 Enrollment ID: I20050214000189 |
| Provider Name | John Bukaty |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588634224 PECOS PAC ID: 2668407602 Enrollment ID: I20050928001305 |
| Provider Name | Lawrence L Ciesemier |
|---|---|
| Provider Type | Practitioner - Allergy/immunology |
| Provider Identifiers | NPI Number: 1952464190 PECOS PAC ID: 2264450659 Enrollment ID: I20051104000211 |
| Provider Name | David Fox |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689639619 PECOS PAC ID: 4082503297 Enrollment ID: I20051128000522 |
| Provider Name | Christopher a Best |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225021140 PECOS PAC ID: 6305882887 Enrollment ID: I20060111001040 |
| Provider Name | Anne E Petersen |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1114968435 PECOS PAC ID: 5799788261 Enrollment ID: I20060823000286 |
| Provider Name | Matthew G Struttmann |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1386676757 PECOS PAC ID: 2365449063 Enrollment ID: I20061020000511 |
| Provider Name | Irene N Parsonson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932275286 PECOS PAC ID: 2567565872 Enrollment ID: I20070307000020 |
| Provider Name | Paul M Rosenthal |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528020039 PECOS PAC ID: 2163310392 Enrollment ID: I20070830000496 |
| Provider Name | Brian K Knowles |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033212279 PECOS PAC ID: 8224125679 Enrollment ID: I20071101000017 |
| Provider Name | Tara L Swan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982773586 PECOS PAC ID: 1153419304 Enrollment ID: I20071121000458 |
| Provider Name | Garrett J Elam |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871522953 PECOS PAC ID: 3577648039 Enrollment ID: I20080307000188 |
| Provider Name | Kelly C Schwager |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316196751 PECOS PAC ID: 5799844627 Enrollment ID: I20081107000103 |
| Provider Name | Erich G Eriksen |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1457516296 PECOS PAC ID: 3678638624 Enrollment ID: I20090209000156 |
| Provider Name | Stephen G Terrill |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1922074533 PECOS PAC ID: 2062416654 Enrollment ID: I20090513000078 |
| Provider Name | Robert P Schneider |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417966573 PECOS PAC ID: 2668440090 Enrollment ID: I20090827000097 |
| Provider Name | Kiana D Long |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285807362 PECOS PAC ID: 5496884397 Enrollment ID: I20100603000019 |
| Provider Name | Karla D Clubine |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265423461 PECOS PAC ID: 6901938828 Enrollment ID: I20100713000120 |
| Provider Name | Arihant Jain |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396910469 PECOS PAC ID: 6709910086 Enrollment ID: I20100823000848 |
| Provider Name | Peter Jay Cleavinger |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1841244191 PECOS PAC ID: 9335108182 Enrollment ID: I20100920000516 |
| Provider Name | Nicolas Llorens |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1174575294 PECOS PAC ID: 3375645096 Enrollment ID: I20100920000536 |
| Provider Name | Michael F Miller |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1710944392 PECOS PAC ID: 7416920764 Enrollment ID: I20110616000057 |
| Provider Name | Yulia Peniston |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1750582516 PECOS PAC ID: 1850492604 Enrollment ID: I20110812000116 |
| Provider Name | Jason J So |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336370162 PECOS PAC ID: 5991956963 Enrollment ID: I20121126000079 |
| Provider Name | Russell T Allen |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1194090357 PECOS PAC ID: 1658500798 Enrollment ID: I20140212001088 |
| Provider Name | Adam M Skinner |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1053310896 PECOS PAC ID: 0143290502 Enrollment ID: I20140319000646 |
| Provider Name | Reggie a Vaden |
|---|---|
| Provider Type | Practitioner - Colorectal Surgery (proctology) |
| Provider Identifiers | NPI Number: 1700983343 PECOS PAC ID: 5294622536 Enrollment ID: I20140425001393 |
| Provider Name | Wyatt-dean a Pickering |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1316178874 PECOS PAC ID: 8325194145 Enrollment ID: I20140822000752 |
| Provider Name | Francisco J Aleman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356618177 PECOS PAC ID: 2365660941 Enrollment ID: I20140822001151 |
| Provider Name | Aaron Lee Rowland |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760405260 PECOS PAC ID: 2961413745 Enrollment ID: I20140903000112 |
| Provider Name | David M Whitmer |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1568789519 PECOS PAC ID: 1658522057 Enrollment ID: I20141013001120 |
| Provider Name | Jeremiah E Yerton |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1568682722 PECOS PAC ID: 5193856920 Enrollment ID: I20141216000082 |
| Provider Name | Christopher Michael Gifford |
|---|---|
| Provider Type | Practitioner - Osteopathic Manipulative Medicine |
| Provider Identifiers | NPI Number: 1982047791 PECOS PAC ID: 7719205434 Enrollment ID: I20150409000744 |
| Provider Name | Eileen N Rowe |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588928139 PECOS PAC ID: 0840431102 Enrollment ID: I20151110002514 |
| Provider Name | Jacqueline Anne Woodrum |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285642199 PECOS PAC ID: 7012801426 Enrollment ID: I20151222001376 |
| Provider Name | Cassandra K From |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073908109 PECOS PAC ID: 8527359256 Enrollment ID: I20161116001492 |
| Provider Name | Elizabeth M Allen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871039917 PECOS PAC ID: 8022391143 Enrollment ID: I20170215000113 |
| Provider Name | Eric James |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1992111751 PECOS PAC ID: 2062710023 Enrollment ID: I20170717002046 |
| Provider Name | Michael D Williams |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1750334470 PECOS PAC ID: 2769495514 Enrollment ID: I20170815000742 |
| Provider Name | Nicholas Madaffer |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1649535824 PECOS PAC ID: 5395978225 Enrollment ID: I20170831002756 |
| Provider Name | Aaron C Neisen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841686029 PECOS PAC ID: 2769784768 Enrollment ID: I20171026003543 |
| Provider Name | Vincent R Hamo |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1215391966 PECOS PAC ID: 3577852490 Enrollment ID: I20180808000882 |
| Provider Name | Amy L Creason |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235610304 PECOS PAC ID: 6406106509 Enrollment ID: I20180911003410 |
| Provider Name | Aunya Marie Cameron |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1346660248 PECOS PAC ID: 3971806795 Enrollment ID: I20181026000021 |
| Provider Name | John M Rayburn |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1346275302 PECOS PAC ID: 9638151616 Enrollment ID: I20190321000779 |
| Provider Name | Madhuresh Kumar |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1356362792 PECOS PAC ID: 5496882466 Enrollment ID: I20190405000355 |
| Provider Name | Julie Ladd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154980159 PECOS PAC ID: 2961737879 Enrollment ID: I20190715003497 |
| Provider Name | Hannah Anderson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073977179 PECOS PAC ID: 9739419557 Enrollment ID: I20190920002812 |
| Provider Name | Miles E Crowley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306339932 PECOS PAC ID: 7416202155 Enrollment ID: I20191121002082 |
| Provider Name | Shirley Louise Arnold |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548821747 PECOS PAC ID: 7517391535 Enrollment ID: I20191230000756 |
| Provider Name | Peter S Gills |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376039560 PECOS PAC ID: 5092140202 Enrollment ID: I20200116001459 |
| Provider Name | Rachael N Brashears |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1427445493 PECOS PAC ID: 2668776303 Enrollment ID: I20200710002862 |
| Provider Name | Bradley W Anderson |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1649533878 PECOS PAC ID: 9830335793 Enrollment ID: I20201216002609 |
| Provider Name | Anne M Hall |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1043294267 PECOS PAC ID: 6709832843 Enrollment ID: I20201221002613 |
| Provider Name | Dalton L Ebel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528611811 PECOS PAC ID: 5193131571 Enrollment ID: I20210309003188 |
| Provider Name | Ethan S Jaeger |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104319748 PECOS PAC ID: 6002161742 Enrollment ID: I20210408000113 |
| Provider Name | Nathan K Woodward |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1750875969 PECOS PAC ID: 3476809708 Enrollment ID: I20210803000186 |
| Provider Name | Gabriel Skiba |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184286510 PECOS PAC ID: 4183012032 Enrollment ID: I20211026000598 |
| Provider Name | Sean Ashkone Bandzar |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1972967461 PECOS PAC ID: 6800134594 Enrollment ID: I20211116003147 |
| Provider Name | Emma L Mallory |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013672104 PECOS PAC ID: 9133519572 Enrollment ID: I20211129002282 |
| Provider Name | Cameron Olsen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1285252973 PECOS PAC ID: 5193116325 Enrollment ID: I20211227000198 |
| Provider Name | Morgan a Dresvyannikov |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386272698 PECOS PAC ID: 0042635385 Enrollment ID: I20220307002128 |
| Provider Name | Dominick Wright |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700487808 PECOS PAC ID: 4880080647 Enrollment ID: I20220404000289 |
| Provider Name | Megan E Rodgers Tschannen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255071627 PECOS PAC ID: 4789071143 Enrollment ID: I20220504000147 |
| Provider Name | Andrew Bennett Wright |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306462775 PECOS PAC ID: 4587087465 Enrollment ID: I20220718001839 |
| Provider Name | Bridgid H Wilson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861929093 PECOS PAC ID: 1254601453 Enrollment ID: I20220728003066 |
| Provider Name | Caleb Joshua Owsley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871157008 PECOS PAC ID: 8628480407 Enrollment ID: I20220816003096 |
| Provider Name | Benjamin Thomas Sundling |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1063831964 PECOS PAC ID: 3274891486 Enrollment ID: I20220902002239 |
| Provider Name | Atabak Asvadi Kermani |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407383870 PECOS PAC ID: 4880963842 Enrollment ID: I20221012003852 |
| Provider Name | Amber D Singer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013632835 PECOS PAC ID: 5395113773 Enrollment ID: I20221115002993 |
| Provider Name | Antoinette M Metzner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295447886 PECOS PAC ID: 5294105029 Enrollment ID: I20230111003037 |
| Provider Name | Rebecca G Bowen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316605801 PECOS PAC ID: 7315318904 Enrollment ID: I20230118001374 |
| Provider Name | Jeanette Dilan-koetje |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538499454 PECOS PAC ID: 5294979399 Enrollment ID: I20230915001328 |
| Provider Name | Mohammad M Hassan |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1326049420 PECOS PAC ID: 9739121781 Enrollment ID: I20231010000437 |
| Provider Name | Alejandro S Curiel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811938616 PECOS PAC ID: 3678463254 Enrollment ID: I20250528001956 |
| Provider Name | Adnan Islam |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1033850284 PECOS PAC ID: 0648650507 Enrollment ID: I20250728000167 |
| Provider Name | Racheal Davidson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1821739962 PECOS PAC ID: 7911387865 Enrollment ID: I20260403002791 |
Brookfield Family Health Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 125 E Lockling St, Brookfield, MO 64628 Phone: 660-258-3363 Fax: 660-258-5409 |
Brookfield Family Health Clinic PC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 624 W. Lockling St, Brookfield, MO 64628 Phone: 660-258-3363 Fax: 660-258-5409 |
Applegate Medical Group Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 130 E Lockling St, Brookfield, MO 64628 Phone: 660-258-1288 Fax: 660-258-4002 |
Advanced Medical Express Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 624 W Lockling St, Brookfield, MO 64628 Phone: 660-268-4006 Fax: 660-258-9006 |
Rivera & Concepcion Med Assoc Ptshp Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 308 N Main St, Brookfield, MO 64628 Phone: 660-258-3324 Fax: 660-258-3325 |
Brookfield Family Health Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 624 West Lockling, Brookfield, MO 64628 Phone: 660-258-3363 Fax: 660-258-5409 |