| Wellspring Healthcare Llc | |
|
6124 Raytown Rd Raytown MO 64133-4007 | |
| (909) 815-3324 | |
| Not Available |
| Full Name | Wellspring Healthcare Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 6124 Raytown Rd, Raytown, Missouri |
| Authorized Official Name and Position | Brian Moore Haas (CEO) |
| Authorized Official Contact | 9098153324 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wellspring Healthcare Llc 705b Se Melody Ln # 184 Lees Summit MO 64063-4380 Ph: (909) 815-3324 | Wellspring Healthcare Llc 6124 Raytown Rd Raytown MO 64133-4007 Ph: (909) 815-3324 |
| NPI Number | 1881363927 |
|---|---|
| Provider Enumeration Date | 09/11/2021 |
| Last Update Date | 09/02/2022 |
| Medicare PECOS PAC ID | 9032509088 |
|---|---|
| Medicare Enrollment ID | O20230925000466 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881363927 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Brian Haas |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033352463 PECOS PAC ID: 8729242474 Enrollment ID: I20120611000271 |
| Provider Name | Preeti Sood |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1245464395 PECOS PAC ID: 3971757626 Enrollment ID: I20130204000432 |
| Provider Name | Hannah P Neenan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750627352 PECOS PAC ID: 9436304961 Enrollment ID: I20130306000318 |
| Provider Name | Michele Duckett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427698224 PECOS PAC ID: 6507293636 Enrollment ID: I20200229000179 |
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