| Ssm Regional Health Services | |
|
140 Northstar Dr Holts Summit MO 65043-1123 | |
| (573) 896-8301 | |
| (573) 896-8589 |
| Full Name | Ssm Regional Health Services |
|---|---|
| Speciality | Clinic/Center |
| Location | 140 Northstar Dr, Holts Summit, Missouri |
| Authorized Official Name and Position | Shasta Rene Manuel (REGIONAL VICE PRESIDENT-FINANCE/CFO) |
| Authorized Official Contact | 4052727282 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ssm Regional Health Services Po Box 1027 Jefferson City MO 65102-1027 Ph: (573) 768-1376 | Ssm Regional Health Services 140 Northstar Dr Holts Summit MO 65043-1123 Ph: (573) 896-8301 |
| NPI Number | 1952357352 |
|---|---|
| Provider Enumeration Date | 05/26/2006 |
| Last Update Date | 05/13/2025 |
| Medicare PECOS PAC ID | 8921917352 |
|---|---|
| Medicare Enrollment ID | O20040819000270 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952357352 | NPI | - | NPPES |
| 502624307 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Dennis M Knapik |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1336147602 PECOS PAC ID: 5698785301 Enrollment ID: I20060426000118 |
| Provider Name | Garry D Pearson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629011812 PECOS PAC ID: 3274630629 Enrollment ID: I20070518000210 |
| Provider Name | Treesa R Riedel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295140432 PECOS PAC ID: 9537384136 Enrollment ID: I20140715000275 |
| Provider Name | Paul E Burris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699100255 PECOS PAC ID: 4486881943 Enrollment ID: I20140721001904 |
| Provider Name | Christopher A Paynter |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760749428 PECOS PAC ID: 1153634795 Enrollment ID: I20150724011839 |
| Provider Name | Ginger E Protzman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104376326 PECOS PAC ID: 9234418005 Enrollment ID: I20161118000335 |
| Provider Name | Joanna L Younker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114278124 PECOS PAC ID: 1254648025 Enrollment ID: I20170928000503 |
| Provider Name | Dayna Lynette Patterson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306349261 PECOS PAC ID: 6204184799 Enrollment ID: I20180731001302 |
| Provider Name | Michelle Leigh Felten |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679045595 PECOS PAC ID: 6305170234 Enrollment ID: I20190627000466 |
| Provider Name | Whitney N Bahner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326735481 PECOS PAC ID: 7012372659 Enrollment ID: I20230503002277 |
| Provider Name | Samuel E Hughes |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316329154 PECOS PAC ID: 9234448234 Enrollment ID: I20240718000427 |
Capital Region Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 180 Northstar St, Holts Summit, MO 65043 Phone: 573-896-5115 Fax: 573-896-4272 |