FIRST MEDICAL GROUP, LLC (NPI# 1023523933) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023523933 |
| Entity Type | Organization |
| Organization Name | FIRST MEDICAL GROUP, LLC |
| Practice Address |
3050 Tucker Rd Poplar Bluff MO 63901-7527 |
| Mailing Address |
231 S Bemiston Ave Ste 850#60336 Saint Louis MO 63105-1920 |
| Practice Telephone | 6362246625 |
| Enumeration Date | 2017-12-14 |
| Last Update Date | 2017-12-14 |
| Authorized Official Name | DEEPU SUDHAKARAN (CEO) |
| Authorized Official Telephone | 6362246625 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| N | 208600000X | Surgery | Allopathic & Osteopathic Physicians | ||
| Y | 207RN0300X |
Internal Medicine Specialization: Nephrology |
Allopathic & Osteopathic Physicians |
| Street Address |
3050 TUCKER RD |
| City | POPLAR BLUFF |
| State | MO |
| Zip Code | 63901-7527 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568076701 | Alternative Sleep Solution | Dentist | 2700 Kanell Blvd., Poplar Bluff, MO 63901 | 2020-09-04 |
| 1285271239 | Front Door Wellness LLC | Physical Therapist | Front Door Wellness LLC, 5835 Quail Meadows Drive, Poplar Bluff, MO 63901 | 2019-12-09 |
| 1104470368 | Andrew Akindutire | Dentist | 3101 Oak Groove Rd., Suite 6, Poplar Bluff, MO 63901 | 2019-07-26 |
| 1780195966 | Midwest Equipment Srv Systems LLC | Technician, Pathology | 2400 Lucy Lee Parkway, Suite C, Poplar Bluff, MO 63901 | 2017-10-16 |
| 1801259387 | Richard Justin Huber | Technician, Other | 3005 Warrior Ln, Poplar Bluff, MO 63901 | 2016-04-01 |
| 1699136275 | Donja Kirkland | Recreation Therapist | 1910a Greenwood Dr., Suite D, Poplar Bluff, MO 63901 | 2016-03-10 |
| 1760866867 | Bio-medical Applications of Missouri, Inc. | Clinic/Center | 3050 Tucker Road, Poplar Bluff, MO 63901 | 2015-07-17 |
| 1407246390 | Lisa Marie Payne | Physical Therapist | 4358c Highway Pp, Poplar Bluff, MO 63901 | 2015-01-29 |
| 1700202488 | Missouri Dental Professionals, Richard Straus, Dmd, PC | Dentist | 1602 W. Harper Street, Poplar Bluff, MO 63901 | 2014-03-05 |
| 1932521648 | Essential Family Healthcare, LLC | Clinic/Center | 1369 North Westwood Blvd., Poplar Bluff, MO 63901 | 2014-01-15 |
| Find all providers in zip 63901 | ||||
| Taxonomy Code | 207RN0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Nephrology |
| An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922289693 | Nephrology Associates, PC | Internal Medicine | 2505 Three Rivers Blvd, Poplar Bluff, MO 63901-2352 | 2007-11-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811549389 | Sana Hasan | Internal Medicine | Ce 422, One Hospital Drive University of Missouri, Columbia, MO 65212-0001 | 2019-07-15 |
| 1295291409 | Zeeshan Azeem | Internal Medicine | 1 Hospital Drive University Hospital, Columbia, MO 65212-0001 | 2019-02-12 |
| 1932614153 | Mohammad Walid Abuzeineh | Internal Medicine | 1 Hospital Drive Department of Nephrology, Columbia, MO 65211-0001 | 2017-12-11 |
| 1548788896 | Nephrology Care of St Louis | Internal Medicine | 224 S Woods Mill Rd Ste 460, Chesterfield, MO 63017-3513 | 2017-09-07 |
| 1033649819 | Taewoo Lee | Internal Medicine | 3635 Vista Ave Saint Louis University Medical Center, Division of Nephrology, Saint Louis, MO 63110 | 2017-06-14 |
| 1528502978 | Bill Lauderdale | Internal Medicine | 288 State Hwy Y, Forsyth, MO 65653-0010 | 2016-12-05 |
| 1780058727 | St Louis Kidney Care LLC | Internal Medicine | 11155 Dunn Rd Ste 211n, Saint Louis, MO 63136-6166 | 2015-11-13 |
| 1104239888 | Sadaf Sheikh | Internal Medicine | 222 S Woods Mill Rd Ste 750n, Chesterfield, MO 63017-3653 | 2014-06-10 |
| 1225441538 | Tomonori Alan Oyadomari | Internal Medicine | 1009 W Saint Maartens Dr Ste F, Saint Joseph, MO 64506-2990 | 2014-06-04 |
| 1184056830 | Ralph Robert Hatlelid | Internal Medicine | 318 E Swon Ave, Saint Louis, MO 63119-3112 | 2013-08-05 |
| Find all providers with the same taxonomy | ||||
| City | POPLAR BLUFF |
| Zip Code | 63901 |
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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.