ST MARYS PHYSICIAN SERVICES, LLC (NPI# 1063626117) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063626117 |
| Entity Type | Organization |
| Organization Name | ST MARYS PHYSICIAN SERVICES, LLC |
| Practice Address |
101 Skyline Dr Russellville AR 72801-3363 |
| Practice Telephone | 4799682345 |
| Practice Fax Number | 4798902497 |
| Mailing Telephone | 4799682345 |
| Mailing Fax Number | 4798902497 |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2019-06-16 |
| Authorized Official Name | KATHY J TEAGUE (SECRETARY) |
| Authorized Official Telephone | 6159206000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | 152955002 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720356207 | St Marys Physician Services, LLC | Internal Medicine | 2205 W Main St, Russellville, AR 72801-2759 | 2011-12-12 |
| Street Address |
101 SKYLINE DR |
| City | RUSSELLVILLE |
| State | AR |
| Zip Code | 72801-3363 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619971140 | Carl I Schoenberger | Internal Medicine | 101 Skyline Dr, Russellville, AR 72801-3363 | 2005-06-13 |
| 1912486648 | Kendra Leann Hubbard | Nurse Practitioner | 101 Skyline Dr, Russellville, AR 72801-3363 | 2018-08-13 |
| 1790286904 | Brittany Lasha Burris | Nurse Practitioner | 101 Skyline Dr, Russellville, AR 72801-3363 | 2018-02-22 |
| 1891294443 | Ashley Nicole Baker | Nurse Practitioner | 101 Skyline Dr, Russellville, AR 72801-3363 | 2018-02-09 |
| 1508233701 | Sparta Corp | Family Medicine | 101 Skyline Dr, Russellville, AR 72801-3363 | 2015-08-24 |
| 1467835611 | Keena Melton | Registered Nurse | 101 Skyline Dr, Russellville, AR 72801-3363 | 2015-07-07 |
| 1194144964 | Noma Wilkinson Kellner | Nurse Practitioner | 101 Skyline Dr, Russellville, AR 72801-3363 | 2014-04-09 |
| 1992049241 | Sarah Minoo Azami | Nurse Practitioner | 101 Skyline Dr, Russellville, AR 72801-3363 | 2012-11-26 |
| 1629336078 | Jonathan David Brixey | Internal Medicine | 101 Skyline Dr, Russellville, AR 72801-3363 | 2012-04-23 |
| 1629343868 | Kelly A Traylor | Nurse Practitioner | 101 Skyline Dr, Russellville, AR 72801-3363 | 2012-03-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962002782 | Randy Paul Stayton | Pharmacist | 2109 W Main, Russellville, AR 72801 | 2020-10-30 |
| 1871134825 | Just Spreading Love Senior Care LLC | Student in an Organized Health Care Education/Training Program | 1411 N. Pittsburg Avenue, Russellville, AR 72801 | 2019-10-01 |
| 1124670369 | Richard L Morgan Dds Pa | Dentist | 1700 West C Place, Russellville, AR 72801 | 2019-07-09 |
| 1407342371 | Andrew James Hickman | Optometrist | 2711 E Parkway Drive, Russellville, AR 72801 | 2018-07-03 |
| 1154859833 | Felicia Head | Speech-Language Pathologist | 220 W 10th St., Russellville, AR 72801 | 2017-05-25 |
| 1295281293 | Arkansas Liver and Gastroenterology, P.a. | Internal Medicine | 1605 West Main Street, Russellville, AR 72801 | 2016-08-30 |
| 1467802405 | Kah Development 4, LLC | Hospice Care, Community Based | 3801 W Main St Ste A, Russellville, AR 72801 | 2016-06-21 |
| 1871904839 | Sleep Partners, LLC | Clinic/Center | 1310 West B Street, Suite A, Russellville, AR 72801 | 2014-05-13 |
| 1942647029 | Rpi Sleep Complete LLC | Clinic/Center | 1310 West Main Street, Suite 201, Russellville, AR 72801 | 2013-05-29 |
| 1184967291 | Amedco Arkansas Pllc | Optometrist | 302 N. Phoenix Ave., Clark Eye Clinic, Russellville, AR 72801 | 2013-03-27 |
| Find all providers in zip 72801 | ||||
| Taxonomy Code | 332B00000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient’s use in the home and that are usable for an extended period of time. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629481395 | Walmart Inc. | Durable Medical Equipment & Medical Supplies | 2109 W Main St, Russellville, AR 72801-4636 | 2014-06-10 |
| 1609048206 | Walgreen Co. | Durable Medical Equipment & Medical Supplies | 485 W 4th St, Russellville, KY 42276-1324 | 2008-03-24 |
| 1750404141 | Alabama Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 14695 Hwy 43, Russellville, AL 35653 | 2007-04-09 |
| 1992877484 | Respi-care Inc. | Durable Medical Equipment & Medical Supplies | 976 Ronnie Mcdowell Ave., Russellville, AL 35654 | 2006-11-14 |
| 1033280276 | Lincare Inc | Durable Medical Equipment & Medical Supplies | 1509 E Main St, Ste 9, Russellville, AR 72801-5326 | 2006-11-10 |
| 1609980028 | Newtons Pharmacy Inc | Durable Medical Equipment & Medical Supplies | 715 West Main, Russellville, AR 72801-3616 | 2006-08-19 |
| 1619982410 | Creekwood Place Nursing & Rehab Center, Inc. | Durable Medical Equipment & Medical Supplies | 107 Boyles Dr, Russellville, KY 42276-8838 | 2006-07-30 |
| 1790702173 | Walmart Inc. | Durable Medical Equipment & Medical Supplies | 2409 E Main St, Russellville, AR 72802-9619 | 2006-07-16 |
| 1275550568 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 13675 Highway 43, Russellville, AL 35653-2831 | 2006-07-16 |
| 1316971161 | Kroger Limited Partnership I | Durable Medical Equipment & Medical Supplies | 1003 W Main St, Russellville, AR 72801-3517 | 2006-07-10 |
| Find all providers in RUSSELLVILLE | ||||
| City | RUSSELLVILLE |
| Zip Code | 72801 |
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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.