DR. AMY COLLEEN MCCLINTOCK (NPI# 1073809141) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073809141 |
| Entity Type | Individual |
| Full Name | DR. AMY COLLEEN MCCLINTOCK |
| Credential | M.D. |
| Practice Address |
12255 De Paul Dr Suite 600 Bridgeton MO 63044-2510 |
| Practice Telephone | 3142095100 |
| Practice Fax Number | 3142095150 |
| Mailing Telephone | 3142095100 |
| Mailing Fax Number | 3142095150 |
| Enumeration Date | 2011-06-27 |
| Last Update Date | 2015-08-06 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QS0010X |
Family Medicine Specialization: Sports Medicine |
2015026147 | MO | Allopathic & Osteopathic Physicians |
| N | 207QS0010X |
Family Medicine Specialization: Sports Medicine |
123806 | OH | Allopathic & Osteopathic Physicians |
| Street Address |
12255 DE PAUL DR SUITE 600 |
| City | BRIDGETON |
| State | MO |
| Zip Code | 63044-2510 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588667497 | Maria Mcfarland | Podiatrist | 12255 De Paul Dr, Suite 500, Bridgeton, MO 63044-2510 | 2005-05-24 |
| 1760846414 | Rachel Heft | Nurse Practitioner | 12255 De Paul Dr, Suite 200, Bridgeton, MO 63044-2510 | 2016-04-08 |
| 1174983878 | Angela R Berry | Nurse Practitioner | 12255 De Paul Dr, Ste 700, Bridgeton, MO 63044-2510 | 2016-02-24 |
| 1922478726 | Darcy L Daniels | Nurse Practitioner | 12255 De Paul Dr, Suite 500, Bridgeton, MO 63044 | 2015-10-06 |
| 1821481474 | Lindsey Rae Duncan | Nurse Practitioner | 12255 De Paul Dr, Suite 865, Bridgeton, MO 63044-2510 | 2015-03-06 |
| 1376884916 | Comfort & Joy Home Health Care Agency | Home Health | 12255 De Paul Dr, Suite 45n, Bridgeton, MO 63044-2510 | 2013-03-06 |
| 1457604878 | Mary F Hans | Nurse Practitioner | 12255 De Paul Dr, 320, Bridgeton, MO 63044-2510 | 2012-10-23 |
| 1528227113 | Eye Physicians of St Louis | Ophthalmology | 12255 De Paul Dr, Bridgeton, MO 63044-2510 | 2008-06-09 |
| 1790943728 | Depaul Optical | Technician/Technologist | 12255 De Paul Dr, Bridgeton, MO 63044-2510 | 2008-05-27 |
| 1205093473 | Asif Bhutto | Internal Medicine | 12255 De Paul Dr, Ste 260, Bridgeton, MO 63044-2510 | 2008-05-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073150017 | Zoe Marie Wadsworth | Nurse Practitioner | 12255 Depaul Dr Suite 300, Bridgeton, MO 63044 | 2019-12-10 |
| 1609412451 | Beyond Better, Best Home Health Care Services, Limited Liability Corpo | In Home Supportive Care | 3430 Mckelvey Road Ste B, Bridgeton, MO 63044 | 2019-11-26 |
| 1275189078 | Delicate Angels Home Health LLC | Home Health | 11726 St. Charles Rock Road Suite G, Bridgeton, MO 63044 | 2019-08-16 |
| 1588210082 | Nicholas Huber | Physical Therapist | 12349 Depaul Dr., Ste. 110, Bridgeton, MO 63044 | 2019-08-12 |
| 1124688858 | Michelle Bassett | Registered Nurse | 11520 St. Charles Rock Rd., Suite 106, Bridgeton, MO 63044 | 2019-06-14 |
| 1336703883 | Elena A Barrow | Nurse Practitioner | 12255 Depaul Dr, Suite 260, Bridgeton, MO 63044 | 2019-04-30 |
| 1487123105 | Laura N Steiner | Registered Nurse | Gateway Pediatrics, Ltd, 12255 Depaul Drive, Suite 460 North Medical Building, Bridgeton, MO 63044 | 2018-11-26 |
| 1205310950 | Danielle Mathis | Nurse Practitioner | 3440 Depaul Lane Suite 201, Bridgeton, MO 63044 | 2018-09-19 |
| 1588163570 | Thoughts Out Loud Counseling, LLC | Social Worker | 11520 St. Charles Rock Road Suite 101, Bridgeton, MO 63044 | 2018-02-06 |
| 1912411430 | Breanna Victoria Hayes | Counselor | 3165 Mckevley Road, Suite 200, Bridgeton, MO 63044 | 2017-11-20 |
| Find all providers in zip 63044 | ||||
| Taxonomy Code | 207QS0010X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Sports Medicine |
| A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation. |
| 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 Family Medicine, 2007. http://www.theabfm.org/. American Osteopathic Board of Family Medicine, 2007. http://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 Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871105312 | 417 Sports Medicine and Orthopedics LLC | Family Medicine | 330 W Plainview Rd Ste F, Springfield, MO 65810-2672 | 2020-08-17 |
| 1871115857 | Ben Heimos | Family Medicine | 1 S Compton Ave, Saint Louis, MO 63103-2001 | 2020-05-12 |
| 1639645070 | Bluetail Biologics LLC | Family Medicine | 17300 N Outer 40 Rd Ste 201, Chesterfield, MO 63005-1364 | 2018-10-23 |
| 1083096671 | Daniel O'loughlin | Family Medicine | 1605 Martin Springs Dr Ste 330, Rolla, MO 65401-2980 | 2015-06-19 |
| 1295175057 | Devin Willis | Family Medicine | 16555 Manchester Rd Ste 100, Wildwood, MO 63040 | 2013-06-26 |
| 1922377274 | Duocorp Enterprises, LLC | Family Medicine | 1525 E Republic Rd, Suite A115, Springfield, MO 65804-6527 | 2011-12-15 |
| 1689960171 | Nathan Lee Granneman | Family Medicine | 200 Corporate Lake Dr, Columbia, MO 65203-7172 | 2011-06-22 |
| 1063568640 | Christian Verry | Family Medicine | 12680 Olive Blvd Ste 300, Saint Louis, MO 63141-6322 | 2007-01-26 |
| 1922116763 | Kristin Suzanne Oliver | Family Medicine | 17300 North Outer 40 Rd Ste 201, Chesterfield, MO 63005-1364 | 2006-08-29 |
| 1942238027 | John J Dougherty | Family Medicine | 1010 Carondelet Dr Ste 220, Kansas City, MO 64114-4822 | 2006-06-29 |
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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.