AMANDA HEIDEMANN (NPI# 1043329105) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043329105 |
| Entity Type | Individual |
| Full Name | AMANDA HEIDEMANN |
| Credential | MD |
| Practice Address |
2630 Highway K O Fallon MO 63368-6624 |
| Mailing Address |
670 Mason Ridge Center Dr Suite 300 Saint Louis MO 63141-8573 |
| Practice Telephone | 6369805300 |
| Practice Fax Number | 6369805344 |
| Mailing Telephone | 6369805300 |
| Mailing Fax Number | 6369805344 |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2012-02-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 2002002039 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 1043329105 | 05 |
| Street Address |
2630 HIGHWAY K |
| City | O FALLON |
| State | MO |
| Zip Code | 63368-6624 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083689061 | John J. O'brien | Family Medicine | 2630 Highway K, O Fallon, MO 63368-6624 | 2006-02-22 |
| 1558929471 | Stacey Elizabeth Brennan | Nurse Practitioner | 2630 Highway K, O Fallon, MO 63368-6624 | 2019-06-05 |
| 1336619782 | Mindy Marie Faraone | Nurse Practitioner | 2630 Highway K, O Fallon, MO 63368-6624 | 2018-11-28 |
| 1407243629 | Cassie Smith | Nurse Practitioner | 2630 Highway K, O Fallon, MO 63368-6624 | 2015-04-26 |
| 1366853541 | Gina Allen | Nurse Practitioner | 2630 Highway K, O Fallon, MO 63368-6624 | 2014-05-10 |
| 1043444342 | Ximena Soledad Schnurr | Family Medicine | 2630 Highway K, O Fallon, MO 63368-6624 | 2009-05-14 |
| 1316130503 | Physician Groups Lc | Orthopaedic Surgery | 2630 Highway K, O Fallon, MO 63368-6624 | 2007-08-22 |
| 1942377387 | Physician Groups Lc | Clinic/Center | 2630 Highway K, O Fallon, MO 63368-6624 | 2006-11-29 |
| 1821164955 | Physician Groups Lc | Clinic/Center | 2630 Highway K, O Fallon, MO 63368-6624 | 2006-11-28 |
| 1508976523 | Liza Stanton | Family Medicine | 2630 Highway K, O Fallon, MO 63368-6624 | 2006-08-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134720329 | Come As You Are Counseling LLC | Counselor | 1001 Boardwalk Springs Place, Suite 111, O Fallon, MO 63368 | 2020-11-04 |
| 1770124802 | Lisa N. Greer | Technician | 6911 Brassel Dr., Ofallon, MO 63368 | 2019-09-30 |
| 1770145716 | Halie Faye Gulley | Dentist | 3009 Hwy K, O'fallon, MO 63368 | 2019-06-29 |
| 1972079556 | Erin Corsi Fraundorf | Dentist | 3009 State Hwy K, O'fallon, MO 63368 | 2018-10-22 |
| 1427579960 | Air Evac Ems, Inc. | Ambulance | 1001 Boardwalk Springs Pl Ste 250, O Fallon, MO 63368 | 2017-07-06 |
| 1528507472 | Washeck Manual Therapy LLC | Clinic/Center | 3074 Winghaven Blvd, O'fallon, MO 63368 | 2017-02-13 |
| 1639618457 | Brittany Hogan | Physical Therapist | 7412 South Outer 364, Suite B, Dardenne Prairie, MO 63368 | 2017-02-13 |
| 1124561469 | Cardinal Home Care LLC | Home Health | 18 Convent Garden Ct, O'fallon, MO 63368 | 2016-11-18 |
| 1336509272 | Sarah Marie Mudd | Counselor | 1654 Bryan Road, O'fallon, MO 63368 | 2016-03-04 |
| 1588023956 | Price-bourisaw Family Chiropractic | Chiropractor | 2917 State Highway K, O Fallon, MO 63368 | 2016-02-15 |
| Find all providers in zip 63368 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477019909 | Family Medical Clinic Pllc | Family Medicine | 1480 N Green Mount Rd Suite 200, O Fallon, IL 62269-3466 | 2019-02-20 |
| 1700351822 | Justin Andrew Steinkamp | Family Medicine | 1002 Peruque Crossing Ct Ste 101, O Fallon, MO 63366-2381 | 2018-10-04 |
| 1912345935 | Jackson Charles Pugh | Family Medicine | 300 Winding Woods Dr Ste 100, O Fallon, MO 63366-5080 | 2013-06-12 |
| 1518228170 | Jaime Rebecca Obszanski | Family Medicine | 1414 Cross St Ste 210, O Fallon, IL 62269 | 2012-05-30 |
| 1427345263 | Alison Juliete Ball | Family Medicine | 2223 Technology Dr, Suite 40, O Fallon, MO 63368-7272 | 2011-06-30 |
| 1083824684 | Amy Elizabeth Grawey | Family Medicine | 207 E Pitman St, O Fallon, MO 63366-2620 | 2007-05-23 |
| 1104991017 | Rema Sanghavi | Family Medicine | 1512 N Green Mount Rd Ste 108, O Fallon, IL 62269 | 2006-11-24 |
| 1316025554 | Robert F Holloway | Family Medicine | 935 Green Briar Hills Dr, O Fallon, MO 63366-5596 | 2006-11-02 |
| 1245287085 | James Robert Lundy | Family Medicine | 320 E Highway 50, O Fallon, IL 62269-2704 | 2006-05-27 |
| 1083689061 | John J. O'brien | Family Medicine | 2630 Highway K, O Fallon, MO 63368-6624 | 2006-02-22 |
| Find all providers in O FALLON | ||||
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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.