MARYVILLE PHYSICIANS SERVICES INC (NPI# 1124261219) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124261219 |
| Entity Type | Organization |
| Organization Name | MARYVILLE PHYSICIANS SERVICES INC |
| Practice Address |
6812 State Route 162 Suite 123 Maryville IL 62062-8553 |
| Mailing Address |
1836 Lackland Hill Pkwy Saint Louis MO 63146-3572 |
| Practice Telephone | 6182889460 |
| Practice Fax Number | 6182889461 |
| Mailing Telephone | 3149890300 |
| Enumeration Date | 2009-04-20 |
| Last Update Date | 2010-02-12 |
| Authorized Official Name | KEITH PAGE (PRESIDENT) |
| Authorized Official Telephone | 6182885711 |
| Is Organization Subpart | Y |
| Parent Organization Name | MARYVILLE PHYSICIANS SERVICES INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207X00000X | Orthopaedic Surgery | Allopathic & Osteopathic Physicians |
| Street Address |
6812 STATE ROUTE 162 SUITE 123 |
| City | MARYVILLE |
| State | IL |
| Zip Code | 62062-8553 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447252978 | Brett R Grebing | Orthopaedic Surgery | 6812 State Route 162, Suite 123, Maryville, IL 62062 | 2005-08-15 |
| 1114454733 | Michael Barajas | Physician Assistant | 6812 State Route 162, Suite 120, Maryville, IL 62062-8553 | 2017-05-12 |
| 1043757867 | Alyssa Ruwe | Nurse Practitioner | 6812 State Route 162, Suite 123, Maryville, IL 62062-8553 | 2017-01-31 |
| 1689092132 | Alyssa Ryanne Goddard Verheyen | Nurse Practitioner | 6812 State Route 162, Suite 202, Maryville, IL 62062-8553 | 2014-04-02 |
| 1922348002 | Laura E. Mckinzie | Nurse Practitioner | 6812 State Route 162, Suite 21, Maryville, IL 62062-8553 | 2013-02-26 |
| 1053656298 | Alan Michael Meredith | Physician Assistant | 6812 State Route 162, Suite 21, Maryville, IL 62062 | 2012-11-28 |
| 1912117912 | Edmundo Alejandro Rodriguez | Internal Medicine | 6812 State Route 162, Suite 204, Maryville, IL 62062 | 2007-05-22 |
| 1942422498 | Ryan Diederich | Surgery | 6812 State Route 162, Maryville, IL 62062-8553 | 2007-05-03 |
| 1922159037 | Kevin Bradley Garner | Internal Medicine | 6812 State Route 162, Suite 204, Maryville, IL 62062-8553 | 2007-01-15 |
| 1700960572 | Rodney L. Greeling | Internal Medicine | 6812 State Route 162, Ste 21, Maryville, IL 62062 | 2006-10-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104325091 | Jennifer M Oyler | Physician Assistant | 6812 State Route 162 Suite 120, Maryville, IL 62062 | 2018-02-06 |
| 1710495965 | Sarah Elizabeth Barto | Family Medicine | 2133 Vadalabene Drive, Suite Sb, Maryville, IL 62062 | 2018-01-22 |
| 1104348085 | Lindsey Nicole Langendorf | Chiropractor | 62 Executive Plaza Ct, Maryville, IL 62062 | 2017-07-12 |
| 1043750540 | Gina Saal | Nurse Anesthetist, Certified Registered | 6800 Rt 162, Maryville, IL 62062 | 2017-03-02 |
| 1548657737 | Karen Michelle Bertels | Emergency Medicine | 6800 Il - 162, Maryville, IL 62062 | 2015-04-25 |
| 1811258148 | Debra Ann Hoelscher | Internal Medicine | 2102 Vadalabene, Maryville, IL 62062 | 2012-06-04 |
| 1538438445 | Casey Elizabeth Wiesemeyer | Speech-Language Pathologist | 2201 Copper Creek Rd, Maryville, IL 62062 | 2011-12-21 |
| 1407144819 | Norah Claire Farley Baker | Family Medicine | 10 Professional Park Dr., Maryville, IL 62062 | 2011-07-19 |
| 1891092474 | Kimberly M Schneider | Physician Assistant | 20b Professional Park Drive, Maryville, IL 62062 | 2011-02-17 |
| 1669782397 | Purandhri Patel | Physical Therapist | 6820 State Route 162, Maryville, IL 62062 | 2010-10-15 |
| Find all providers in zip 62062 | ||||
| Taxonomy Code | 207X00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588847446 | The Center for Advanced Orthopedics, LLC | Orthopaedic Surgery | 6812 State Rte 162, 123, Maryville, IL 62062-8500 | 2007-12-13 |
| 1669563409 | Orthotennessee, PC | Orthopaedic Surgery | 827 E Lamar Alexander Pkwy, Maryville, TN 37804-5001 | 2006-09-27 |
| 1801864012 | Michael Lyle Campbell | Orthopaedic Surgery | 827 Lamar Alexander Pkwy, Maryville, TN 37802 | 2006-03-14 |
| 1447252978 | Brett R Grebing | Orthopaedic Surgery | 6812 State Route 162, Suite 123, Maryville, IL 62062 | 2005-08-15 |
| 1740609924 | Elizabeth Anne Mcbride | Orthopaedic Surgery | 827 E Lamar Alexander Pkwy, Maryville, TN 37804-5001 | 2014-04-15 |
| 1801024229 | Justin B Jones | Orthopaedic Surgery | 827 E Lamar Alexander Pkwy, Maryville, TN 37804 | 2009-06-24 |
| 1689832735 | Jay Wesley Winn | Orthopaedic Surgery | 827 E Lamar Alexander Pkwy, Maryville, TN 37804-5001 | 2008-05-27 |
| 1396961785 | Brandon Shane Asbury | Orthopaedic Surgery | 827 E Lamar Alexander Pkwy, Maryville, TN 37804-5001 | 2007-04-17 |
| 1861461600 | Todd Robert Griffith | Orthopaedic Surgery | 827 Lamar Alexander Pkwy, Maryville, TN 37802 | 2006-03-15 |
| 1124096318 | Eric A Morgan | Orthopaedic Surgery | 827 Lamar Alexander Pkwy, Maryville, TN 37802 | 2006-03-14 |
| Find all providers in MARYVILLE | ||||
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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.