EDWIN DEAN BRESHEARS (NPI# 1154417178) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154417178 |
| Entity Type | Individual |
| Full Name | EDWIN DEAN BRESHEARS |
| Credential | M.D. |
| Practice Address |
3308 West Edgewood Suite B Jefferson City MO 65109-6891 |
| Practice Telephone | 5738937848 |
| Practice Fax Number | 5738931984 |
| Mailing Telephone | 5738937848 |
| Mailing Fax Number | 5738931984 |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2020-09-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | R7213 | MO | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | R7213 | MO | Allopathic & Osteopathic Physicians |
| Street Address |
3308 WEST EDGEWOOD SUITE B |
| City | JEFFERSON CITY |
| State | MO |
| Zip Code | 65109-6891 |
| 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 | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851484349 | Vickie Jean Park | Emergency Medicine | 100 St. Mary's Medical Plaza, Jefferson City, MO 65101 | 2006-10-02 |
| 1467465799 | Charles Wayne Judy | Emergency Medicine | 100 St Marys Health Plaza, Jefferson City, MO 65101 | 2006-08-15 |
| 1255340113 | William Donald Musick | Emergency Medicine | 100 St. Mary's Plaza, Jefferson City, MO 65201 | 2006-08-07 |
| 1992786693 | Michael D. Wilson | Emergency Medicine | 1036 Satinwood Ct, Jefferson City, MO 65109-1809 | 2005-11-09 |
| 1477548352 | Thomas B Nittler | Emergency Medicine | 100 Saint Marys Plz, Jefferson City, MO 65101-1602 | 2005-09-15 |
| 1821531625 | Meadow Spring Primary Care | Emergency Medicine | 1526 Meadow Spring Dr, Jefferson City, TN 37760 | 2016-11-28 |
| 1174979520 | Jefferson City Medical Group, PC | Emergency Medicine | 1735 Elm Court, Jefferson City, MO 65101 | 2016-05-04 |
| 1346655636 | Jared Emery | Emergency Medicine | 1125 Madison St, Jefferson City, MO 65101-5227 | 2014-06-25 |
| 1912249814 | Joshua Porter | Emergency Medicine | 110 Hospital Dr, Jefferson City, TN 37760-5281 | 2013-03-19 |
| 1205152105 | Richard Baird | Emergency Medicine | 110 Hospital Dr, Jefferson City, TN 37760-5281 | 2010-04-16 |
| 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.