OZARKS MEDICAL CENTER (NPI# 1194014399) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194014399 |
| Entity Type | Organization |
| Organization Name | OZARKS MEDICAL CENTER |
| Other Organization Name | OZARKS MEDICAL CENTER HEART CARE SERVICES |
| Practice Address |
1115 Alaska St Ste 114 West Plains MO 65775-2000 |
| Mailing Address |
Po Box 1100 West Plains MO 65775-1100 |
| Practice Telephone | 4172575950 |
| Mailing Telephone | 4172569111 |
| Enumeration Date | 2011-03-29 |
| Last Update Date | 2017-05-03 |
| Authorized Official Name | THOMAS W KELLER (PRESIDENT AND CEO) |
| Authorized Official Telephone | 4172569111 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Ozarks Medical Center Heart Care Services | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598373359 | Ozarks Medical Center | Clinic/Center | Omc/zizzer Clinic, 1013 College Street, West Plains, MO 65775 | 2020-07-17 |
| 1427526565 | Ozarks Medical Center | Clinic/Center | 201 West High Street, Suite 2, Willow Springs, MO 65793 | 2018-11-07 |
| 1124514476 | Ozarks Medical Center | Clinic/Center | 201 West High Street, Suite 2, Willow Springs, MO 65793 | 2018-07-10 |
| 1780959684 | Ozarks Medical Center | Pharmacy | 18 Parkway Center, West Plains, MO 65775 | 2012-03-12 |
| 1750680146 | Ozarks Medical Center | Internal Medicine | 1115 Alaska St Ste 215, West Plains, MO 65775-2014 | 2011-03-24 |
| 1326213406 | Ozarks Medical Center | Ambulance | Hc 1 Box 31, Gainesville, MO 65655-9601 | 2008-04-29 |
| 1871768952 | Ozarks Medical Center | Ambulance | 203 Front St, Thayer, MO 65791-1220 | 2008-04-29 |
| 1679600936 | Ozarks Medical Center | Clinic/Center | 172 Hwy 62 East, Suite 1, Salem, AR 72576 | 2007-02-27 |
| 1649306002 | Ozarks Medical Center | Clinic/Center | 260 S Main Street, Mammoth Spring, AR 72554-7466 | 2007-02-27 |
| 1730215195 | Ozarks Medical Center | Clinic/Center | 1375 Nettleton Avenue, Thayer, MO 65791 | 2007-02-27 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | OZARKS MEDICAL CENTER | 1100 Kentucky Ave, West Plains, MO 65775-2029 |
| Street Address |
1115 ALASKA ST STE 114 |
| City | WEST PLAINS |
| State | MO |
| Zip Code | 65775-2000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023087764 | William Anthony Mcgee | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1115 Alaska St Ste 114, West Plains, MO 65775 | 2006-03-15 |
| 1053734657 | Praveen Datar | Internal Medicine | 1115 Alaska St Ste 114, West Plains, MO 65775-2000 | 2014-02-03 |
| 1841622008 | Hussain Ibrahim | Internal Medicine | 1115 Alaska St Ste 114, West Plains, MO 65775-2000 | 2013-07-30 |
| 1053673160 | Biplab Kumar Saha | Internal Medicine | 1115 Alaska St Ste 114, West Plains, MO 65775 | 2012-06-13 |
| 1588743868 | Achenkunju K George | Internal Medicine | 1115 Alaska St Ste 114, West Plains, MO 65775-2000 | 2006-11-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598373359 | Ozarks Medical Center | Clinic/Center | Omc/zizzer Clinic, 1013 College Street, West Plains, MO 65775 | 2020-07-17 |
| 1962958678 | Fanny Ray | Massage Therapist | 1105 Independence Drive, West Plains, MO 65775 | 2016-09-01 |
| 1295184166 | Shaunda Faye Wolfe | Case Manager/Care Coordinator | 2301 K Hwy Apt. 2, West Plains, MO 65775 | 2016-06-10 |
| 1740694009 | Mary Loretta Rogganbuck | Counselor | 1211 Porter Wagoner #23, West Plains, MO 65775 | 2014-06-16 |
| 1548673858 | John Tollenaar | Physical Therapist | 1480 8th Streeet, West Plains, MO 65775 | 2014-06-04 |
| 1861818080 | Raymond Eugene Richardson | Case Manager/Care Coordinator | 1015 Lanton Road, West Plains, MO 65775 | 2014-03-12 |
| 1710309083 | Jared M Sadowitz | Physical Therapist | 1100 Kentucly Ave, West Plains, MO 65775 | 2014-01-06 |
| 1346682184 | Mark L. Dake Dds, Msd and David Sander Dmd, Mds | Dentist | 181 N. Kentucky, Suite 300, West Plains, MO 65775 | 2013-07-22 |
| 1427307024 | Anita M. Nelson | Behavioral Analyst | 8388 Pr 2731, West Plains, MO 65775 | 2012-08-29 |
| 1780959684 | Ozarks Medical Center | Pharmacy | 18 Parkway Center, West Plains, MO 65775 | 2012-03-12 |
| Find all providers in zip 65775 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841593571 | Cardiology of The Ozarks LLC | Internal Medicine | 780 N Kentucky Ave, West Plains, MO 65775-2013 | 2010-12-20 |
| 1366575151 | Muhammad F Khan | Internal Medicine | 1115 Alaska Ave, Suite 114, West Plains, MO 65775 | 2007-03-13 |
| 1164404331 | Kevin E Crowe | Internal Medicine | 1115 Alaska St, Suite 114, West Plains, MO 65775-2061 | 2005-11-15 |
| 1386932978 | Archana Sinha | Internal Medicine | 1100 N Kentucky Ave, West Plains, MO 65775-2029 | 2011-07-15 |
| 1588743868 | Achenkunju K George | Internal Medicine | 1115 Alaska St Ste 114, West Plains, MO 65775-2000 | 2006-11-06 |
| 1255303855 | Alan D Troy | Internal Medicine | 1115 Alaska St, West Plains, MO 65775-2061 | 2006-02-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689128019 | Midwest Heart Institute | Internal Medicine | 1439 Us Highway 61, Ste A, Festus, MO 63028-4153 | 2016-08-15 |
| 1477984292 | Robert A. Brinkman, M.d., LLC. | Internal Medicine | 1040 N Mason Rd Ste 211, Creve Coeur, MO 63141 | 2013-12-04 |
| 1528407822 | Justin Patrick Sheehy | Internal Medicine | 4401 Wornall Rd Fl 9, Kansas City, MO 64111-3220 | 2013-06-19 |
| 1952643520 | Meritas Health Corporation | Internal Medicine | 5501 Nw 62nd Ter Ste 201, Kansas City, MO 64151-2408 | 2013-03-21 |
| 1043557150 | Ronald Nathan Riner | Internal Medicine | 9847 Waterbury Drive, St. Louis, MO 63124 | 2013-01-09 |
| 1427315423 | Paul Larsen | Internal Medicine | 1027 Bellevue Ave Ste 200, Saint Louis, MO 63117-1851 | 2012-04-13 |
| 1275899718 | Bradley Carl Witbrodt | Internal Medicine | 3023 N Ballas Rd Ste 200, Saint Louis, MO 63131-2330 | 2012-04-10 |
| 1194004952 | Jad Raffoul | Internal Medicine | 1402 S Grand Blvd Fl 14, Saint Louis, MO 63104-1004 | 2011-08-11 |
| 1376839894 | Chetan P Huded | Internal Medicine | 5844 Nw Barry Rd Ste 230, Kansas City, MO 64154-1421 | 2011-06-22 |
| 1982999462 | Philip L Mar | Internal Medicine | 3635 Vista Ave Fl 15, Saint Louis, MO 63110-2539 | 2011-06-13 |
| Find all providers with the same taxonomy | ||||
| City | WEST PLAINS |
| Zip Code | 65775 |
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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.