JAMES G LIESEN (NPI# 1003815291) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003815291 |
| Entity Type | Individual |
| Full Name | JAMES G LIESEN |
| Credential | DO |
| Practice Address |
1195 N Oakland Ave Suite 2 Bolivar MO 65613-8095 |
| Mailing Address |
1500 N Oakland Ave Bolivar MO 65613-3011 |
| Practice Telephone | 4177772121 |
| Practice Fax Number | 4177772854 |
| Mailing Telephone | 4173286501 |
| Mailing Fax Number | 4173286338 |
| Enumeration Date | 2005-07-19 |
| Last Update Date | 2017-02-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 2008032320 | MO | Allopathic & Osteopathic Physicians |
| N | 208000000X | Pediatrics | 2101 | WV | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WV | 3810002037 | 05 |
| Street Address |
1195 N OAKLAND AVE SUITE 2 |
| City | BOLIVAR |
| State | MO |
| Zip Code | 65613-8095 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023306388 | Ashley Michele Lane | Obstetrics & Gynecology | 1195 N Oakland Ave, Bolivar, MO 65613-8095 | 2011-07-20 |
| 1942414610 | Citizens Memorial Healthcare | Clinic/Center | 1195 N Oakland Ave, Suite 2, Bolivar, MO 65613-8095 | 2007-05-10 |
| 1629120506 | Angela D Collins | Pediatrics | 1195 N Oakland Ave, Suite 2, Bolivar, MO 65613-8095 | 2007-01-18 |
| 1902919814 | Shannon Leigh Calvert | Pediatrics | 1195 N Oakland Ave, Suite 2, Bolivar, MO 65613-8095 | 2006-08-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891301552 | Casablanca Care Center, LLC | Home Health | 524 S. Albany Avenue, Bolivar, MO 65613 | 2020-09-18 |
| 1669087045 | Revive Medical LLC | Durable Medical Equipment & Medical Supplies | 5000, S Scenic, Bolivar, MO 65613 | 2020-09-11 |
| 1669097119 | Melanie Nicole Beckham | Nurse Practitioner | 1100 South Springfield Ave, Suite B, Bolivar, MO 65613 | 2020-06-10 |
| 1932754744 | Caitlin M Williams | Specialist/Technologist | 1260 S Pike Avenue, Bolivar, MO 65613 | 2019-08-08 |
| 1073022406 | Jacquelyn Rose Kemnic | Dietitian, Registered | Heart Center, 1500 N Oakland Ave, Willard, MO 65613 | 2017-09-28 |
| 1164897161 | Ozarks Resource Group | Clinic/Center | 203 E. Broadway St., Bolivar, MO 65613 | 2015-12-02 |
| 1962895292 | Professional Christian Counseling | Counselor | 4888 S 139th Road, Bolivar, MO 65613 | 2015-03-11 |
| 1073916573 | Scott Leslie Dennis | Physician Assistant | 1500 North Oakland Ave, Citizens Memorial Hospital, Bolivar, MO 65613 | 2014-09-29 |
| 1053712109 | Citizens Memorial Hospital District | Pharmacy | 1301-b North Oakland, Bolivar, MO 65613 | 2014-09-09 |
| 1740680453 | Jamee M Stimpson | Occupational Therapist | 454 S. Main Avenue, Bolivar, MO 65613 | 2014-08-29 |
| Find all providers in zip 65613 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982606497 | Richard Mast Reinhard IIi | Pediatrics | 629 Nuckolls Rd, Bolivar, TN 38008 | 2005-08-15 |
| 1629120506 | Angela D Collins | Pediatrics | 1195 N Oakland Ave, Suite 2, Bolivar, MO 65613-8095 | 2007-01-18 |
| 1508979402 | Maida Patricia Baugh | Pediatrics | 1165 N Butterfield Rd, Bolivar, MO 65613-1056 | 2006-08-16 |
| 1902919814 | Shannon Leigh Calvert | Pediatrics | 1195 N Oakland Ave, Suite 2, Bolivar, MO 65613-8095 | 2006-08-16 |
| 1336123009 | Rahaman Olatunji Suara | Pediatrics | 629 Nuckolls Rd, Bolivar, TN 38008-1599 | 2005-12-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114537222 | Natalie Joan Wilson | Pediatrics | 1463 Us Hwy 61, Suite C, Festus, MO 63028-6302 | 2020-08-04 |
| 1538786413 | Melissa An | Pediatrics | 1 Childrens Pl Ste 3s36, Saint Louis, MO 63110-1002 | 2020-06-26 |
| 1033731500 | Jessica N Zeiss | Pediatrics | 981 Highway K, Rhineland, MO 65069-2214 | 2020-05-07 |
| 1538795547 | Virtualnicu | Pediatrics | 10 Warridge Dr, Saint Louis, MO 63124-1166 | 2020-03-21 |
| 1811528656 | Children's Mercy-cockerell and Mcintosh Pediatrics, Inc | Pediatrics | 205 Nw R D Mize Rd Ste 304, Blue Springs, MO 64014-2520 | 2020-01-30 |
| 1134780430 | Jane Reardon | Pediatrics | 8140 Ward Pkwy Ste 275, Kansas City, MO 64114-2032 | 2019-06-26 |
| 1174082887 | Kristen Steinmeyer | Pediatrics | 714 Peace Haven Ct, Saint Louis, MO 63125-5404 | 2019-03-13 |
| 1023574365 | Saint Francis Medical Center | Pediatrics | 2210 Barron Rd Ste 120, Poplar Bluff, MO 63901-1908 | 2019-02-12 |
| 1215402011 | Ayse Bahar Budan Caliskan | Pediatrics | Washington University, St. Louis Children's Hospital, One Children's Place, 4n1, St. Louis, MO 63110-1002 | 2018-10-08 |
| 1336634500 | Martin K Mwangi | Pediatrics | 1 Childrens Place, 3s34, St. Louis, M, MO 63110 | 2018-06-28 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.