| Smdh Family Medicine | |
|
35629 Hwy. 72 Bld. 3 Salem MO 65560-0719 | |
| (573) 739-6020 | |
| (573) 739-6021 |
| Full Name | Smdh Family Medicine |
|---|---|
| Speciality | Clinic/Center |
| Location | 35629 Hwy. 72, Salem, Missouri |
| Authorized Official Name and Position | Dennis P Pryor (HOSPITAL ADMINISTRATOR) |
| Authorized Official Contact | 5737296626 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Smdh Family Medicine P.o. Box 719 Salem MO 65560-0719 Ph: (573) 739-6020 | Smdh Family Medicine 35629 Hwy. 72 Bld. 3 Salem MO 65560-0719 Ph: (573) 739-6020 |
| NPI Number | 1114177557 |
|---|---|
| Provider Enumeration Date | 09/23/2008 |
| Last Update Date | 02/21/2014 |
| Medicare PECOS PAC ID | 7012801129 |
|---|---|
| Medicare Enrollment ID | O20040210000857 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114177557 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Barry Joseph Waack |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1710941299 PECOS PAC ID: 3173516150 Enrollment ID: I20040406000433 |
| Provider Name | Shannon M Jennings |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1285715847 PECOS PAC ID: 8224003017 Enrollment ID: I20040826000272 |
| Provider Name | Charles Alan Featherly |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1194762542 PECOS PAC ID: 2466418678 Enrollment ID: I20041208000933 |
| Provider Name | Rodger S Campbell |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1336192582 PECOS PAC ID: 6800847682 Enrollment ID: I20050209000565 |
| Provider Name | Julius F Punzalan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1366513376 PECOS PAC ID: 6103867478 Enrollment ID: I20050517000585 |
| Provider Name | Jimmy D Bell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447305412 PECOS PAC ID: 6406899095 Enrollment ID: I20050606000097 |
| Provider Name | Blake Little |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1386688778 PECOS PAC ID: 0749172237 Enrollment ID: I20050616000216 |
| Provider Name | Naser M Almasalmeh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1184698243 PECOS PAC ID: 4183655715 Enrollment ID: I20050824000146 |
| Provider Name | Shukri M Abdullah |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861444879 PECOS PAC ID: 9537187554 Enrollment ID: I20051109000023 |
| Provider Name | Terry L Bruno |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013954049 PECOS PAC ID: 4385645357 Enrollment ID: I20070118000521 |
| Provider Name | Randy V Kellenberger |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1932186681 PECOS PAC ID: 7012817927 Enrollment ID: I20070827000381 |
| Provider Name | Sandra K Headrick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891786414 PECOS PAC ID: 8426138421 Enrollment ID: I20080103000308 |
| Provider Name | Anne M De Lonais-turner |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1114062387 PECOS PAC ID: 4880773860 Enrollment ID: I20080501000398 |
| Provider Name | Franklin E Mayhue |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1669428421 PECOS PAC ID: 2668530882 Enrollment ID: I20081016000394 |
| Provider Name | Mohammad Jarbou |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396830915 PECOS PAC ID: 4385703578 Enrollment ID: I20081103000378 |
| Provider Name | Craig E Tatom |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225286347 PECOS PAC ID: 1153485784 Enrollment ID: I20090127000444 |
| Provider Name | Roberto Antonio Moran-bojorquez |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1063689651 PECOS PAC ID: 5597811893 Enrollment ID: I20090928000367 |
| Provider Name | John Demorlis |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659442028 PECOS PAC ID: 0648313601 Enrollment ID: I20100130000161 |
| Provider Name | Yvonne M Prince |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538150222 PECOS PAC ID: 7618012055 Enrollment ID: I20100309000891 |
| Provider Name | James W Neely |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962486951 PECOS PAC ID: 7911036603 Enrollment ID: I20100518000406 |
| Provider Name | Elizabeth A Lambird |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255360731 PECOS PAC ID: 5092794966 Enrollment ID: I20100729000817 |
| Provider Name | Mark D Brecheisen |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1740503416 PECOS PAC ID: 4082730544 Enrollment ID: I20120725000626 |
| Provider Name | Jonathan R Beers |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1477783686 PECOS PAC ID: 0244419851 Enrollment ID: I20121024000407 |
| Provider Name | Sarfaraz Jasdanwala |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851646665 PECOS PAC ID: 8426364258 Enrollment ID: I20150825003318 |
| Provider Name | Morris S Glover |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1447416862 PECOS PAC ID: 6608933080 Enrollment ID: I20160419002658 |
| Provider Name | Hatem Hamed |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841434404 PECOS PAC ID: 7911145032 Enrollment ID: I20181106000437 |
| Provider Name | Ryan M Shaffer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679053813 PECOS PAC ID: 0244584027 Enrollment ID: I20181114000846 |
| Provider Name | Tiffany Gail Bland |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447755848 PECOS PAC ID: 9537413018 Enrollment ID: I20181120001045 |
| Provider Name | Mandi Nicole Parks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760966188 PECOS PAC ID: 9638413925 Enrollment ID: I20181127001566 |
| Provider Name | Brian Andrew Tessaro |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1043693724 PECOS PAC ID: 9638416654 Enrollment ID: I20190627001162 |
| Provider Name | Gregory Renck |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1275645400 PECOS PAC ID: 2668557455 Enrollment ID: I20190703000577 |
| Provider Name | Samantha D Welch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932734092 PECOS PAC ID: 7517397573 Enrollment ID: I20200415002855 |
| Provider Name | Justin Daniel Hornbeck |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1598262503 PECOS PAC ID: 0648609495 Enrollment ID: I20210614001012 |
| Provider Name | Ralph A Ford |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1194704080 PECOS PAC ID: 8729218300 Enrollment ID: I20211230000987 |
| Provider Name | Michelle Lynn Bland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114675501 PECOS PAC ID: 3375921604 Enrollment ID: I20220527001064 |
| Provider Name | Dwayne Narayan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1083619951 PECOS PAC ID: 5597909192 Enrollment ID: I20220831000789 |
| Provider Name | James Lamousin |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1043227606 PECOS PAC ID: 8022000215 Enrollment ID: I20220831000956 |
| Provider Name | Jourdan Aromin |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1598150955 PECOS PAC ID: 4082942776 Enrollment ID: I20220902002844 |
| Provider Name | Amber A. Hogan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831814060 PECOS PAC ID: 0446627533 Enrollment ID: I20221102001331 |
Charles W Cunningham Do Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1010 Hwy 32 East, Salem, MO 65560 Phone: 573-729-5533 Fax: 573-729-7754 | |
Phelps Health Medical Group Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1415 W Scenic Rivers Blvd, Salem, MO 65560 Phone: 573-729-5533 Fax: 573-202-2466 | |
Mercy Clinic Family Medicine-salem Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 404 W Rolla Rd, Salem, MO 65560 Phone: 573-729-6225 Fax: 573-729-7258 | |
South Central Missouri Community Health Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 601 S Mcarthur St, Salem, MO 65560 Phone: 573-426-2407 Fax: 573-426-6723 | |
Smdh Family Health Care Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 35629 Highway 72 Bldg Ii, Salem, MO 65560 Phone: 573-729-6112 Fax: 573-729-4035 | |
Smdh Family Medicine Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 35629 Hwy 72, Bld. 3, Salem, MO 65560 Phone: 573-729-8000 Fax: 573-729-8001 |