SHADI MAHER HADDADIN (NPI# 1073611919) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073611919 |
| Entity Type | Individual |
| Full Name | SHADI MAHER HADDADIN |
| Credential | MD |
| Practice Address |
1241 W Stadium Blvd Jefferson City MO 65109-6023 |
| Mailing Address |
Po Box 104240 Jefferson City MO 65110-4240 |
| Practice Telephone | 5735567718 |
| Mailing Telephone | 5736355264 |
| Mailing Fax Number | 5735565757 |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2014-12-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
2008003781 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | RAILROAD MEDICARE | P00724818 | 01 |
| MO | 1073611919 | 05 | |
| MO | TRICARE WEST | 431560263 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033582143 | Shadi Haddadin | Pharmacist | 2480 Victoria Ave, Port Hueneme, CA 93041-2141 | 2015-11-11 |
| Street Address |
1241 W STADIUM BLVD |
| City | JEFFERSON CITY |
| State | MO |
| Zip Code | 65109-6023 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801899851 | Robert E Ferris | Specialist | 1241 W Stadium Blvd, Jefferson City, MO 65109-6023 | 2005-05-23 |
| 1013542109 | Ashlee Kathleen Parkes | Nurse Practitioner | 1241 W Stadium Blvd, Jefferson City, MO 65109-6023 | 2020-03-09 |
| 1508498601 | Samantha Michelle Findley | Nurse Practitioner | 1241 W Stadium Blvd, Jefferson City, MO 65109-6023 | 2020-02-06 |
| 1891335360 | Carson Mikaela Borgmeyer | Nurse Practitioner | 1241 W Stadium Blvd, Jefferson City, MO 65109-6023 | 2020-01-13 |
| 1215570585 | Cortny Osie-ann Vandergrift | Nurse Practitioner | 1241 W Stadium Blvd, Jefferson City, MO 65109-6023 | 2019-10-19 |
| 1912569906 | Sarah Loveland Jennett | Nurse Practitioner | 1241 W Stadium Blvd, Jefferson City, MO 65109-6023 | 2019-07-01 |
| 1699339754 | Sumnima Neupane | Nurse Anesthetist, Certified Registered | 1241 W Stadium Blvd, Jefferson City, MO 65109-6023 | 2019-04-24 |
| 1720545999 | Angela Kay Watkins | Nurse Practitioner | 1241 W Stadium Blvd, Jefferson City, MO 65109-6023 | 2019-02-25 |
| 1811471667 | Morgan Elizabeth Grace Su | Nurse Practitioner | 1241 W Stadium Blvd, Jefferson City, MO 65109-6023 | 2018-09-18 |
| 1780105007 | Jennifer Lynn Adelman | Registered Nurse | 1241 W Stadium Blvd, Jefferson City, MO 65109-6023 | 2017-06-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518449321 | Kara D Roderick | Physical Therapist | 1115 Fairgrounds Road, Jefferson City, MO 65109 | 2018-08-29 |
| 1851871214 | Integrative Medicine, LLC | Internal Medicine | 999 Diamond Rdg Ste 201, Jefferson City, MO 65109 | 2018-08-15 |
| 1972020394 | Rehab Care Group East, LLC | Clinic/Center | Primrose Retirement Community Jefferson City, 1214 Freedom Boulevard, Jefferson City, MO 65109 | 2017-08-25 |
| 1124558986 | Nicholas Rehagen | Specialist/Technologist | 304 Timber Creek Rd, Jefferson City, MO 65109 | 2017-06-14 |
| 1982004214 | Kara Elizabeth Wilbers | Occupational Therapist | 1105 Fairgrounds Rd, Jefferson City, MO 65109 | 2014-08-22 |
| 1942510334 | Loftin Eyecare, LLC | Optometrist | 724 West Stadium Boulevard, # 029 Walmart Vision Center, Jefferson City, MO 65109 | 2010-10-19 |
| 1306077250 | Paula Hancock Johnson | Social Worker | 1303 Edgewood Dr Ste 5, Jefferson City, MO 65109 | 2009-07-27 |
| 1679701296 | Capital Region Medical Center | Family Medicine | 3308 W Edgewood, Suite B, Jefferson City, MO 65109 | 2009-06-23 |
| 1972730141 | Nancy S Stork | Counselor | 204 Metro, Suite B, Jefferson City, MO 65109 | 2009-06-16 |
| 1356522916 | Walk Easy LLC | Durable Medical Equipment & Medical Supplies | 4810 Rainbow Dr., Jefferson City, MO 65109 | 2007-11-23 |
| Find all providers in zip 65109 | ||||
| Taxonomy Code | 207RH0003X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Hematology & Oncology |
| An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477782092 | Tamara V Hopkins, Md, LLC | Internal Medicine | 2009 Saint Marys Blvd Ste A, Jefferson City, MO 65109-1509 | 2009-07-02 |
| 1457591463 | David Douglas Westhoff | Internal Medicine | 3605 Missouri Blvd, Jefferson City, MO 65109-7111 | 2009-03-03 |
| 1356436802 | Joseph J Doggett | Internal Medicine | 1432 Southwest Boulevard, Jefferson City, MO 65109 | 2006-10-03 |
| 1144226465 | Tamara Vann Hopkins | Internal Medicine | 1241 W. Stadium Blvd., Jefferson City, MO 65109-6023 | 2005-06-22 |
| 1093184558 | Tennessee Cancer Specialists, Pllc | Internal Medicine | 120 Hospital Drive, Ste G50, Jefferson City, TN 37760-7730 | 2015-09-15 |
| 1033379938 | Rolando Daniel Breier | Internal Medicine | 1241 W Stadium Blvd, Jefferson City, MO 65109-6023 | 2008-06-13 |
| 1831247519 | Tennessee Cancer Specialists Pllc | Internal Medicine | 110 Hospital Dr, St Mary's Jefferson Memorial Hospital, Jefferson City, TN 37760-5281 | 2007-01-08 |
| 1760530927 | Tennessee Cancer Specialists, Pllc | Internal Medicine | 110 Hospital Dr, Suite G50, Jefferson City, TN 37760-5281 | 2007-01-06 |
| 1215093257 | Jefferson City Medical Group, P.C. | Internal Medicine | 1241 W Stadium Blvd, Second Floor, Suite 2300, Jefferson City, MO 65109-6023 | 2006-12-27 |
| 1467411488 | Ali Khojasteh | Internal Medicine | 1241 W Stadium Blvd, Jefferson City, MO 65109-6023 | 2006-03-20 |
| Find all providers in JEFFERSON CITY | ||||
| City | JEFFERSON CITY |
| Zip Code | 65109 |
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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.