FAMILY HEALTH AND WELLNESS CLINIC, LLC (NPI# 1215436696) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215436696 |
| Entity Type | Organization |
| Organization Name | FAMILY HEALTH AND WELLNESS CLINIC, LLC |
| Practice Address |
148 S Main Liberal MO 64762-0000 |
| Mailing Address |
Po Box 13 Liberal MO 64762-0013 |
| Practice Telephone | 5735692046 |
| Mailing Telephone | 5735692046 |
| Mailing Fax Number | 4178432035 |
| Enumeration Date | 2018-02-12 |
| Last Update Date | 2018-02-27 |
| Authorized Official Name | CARLA MICHELLE REED (MEMBER/FNP-BC) |
| Authorized Official Telephone | 5735692046 |
| Authorized Official Credential | FNP-BC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| Street Address |
148 S MAIN |
| City | LIBERAL |
| State | MO |
| Zip Code | 64762-0000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083168785 | Carla Reed | Registered Nurse | 148 S Main St, Liberal, MO 64762 | 2016-08-10 |
| 1053882563 | Regional Services | Nurse Practitioner | 205 N Payne St, Liberal, MO 64762-9263 | 2018-12-10 |
| 1902003114 | Denise Elaine Dickens | Counselor | 125 S Main St, Liberal, MO 64762-9313 | 2007-06-29 |
| 1649276924 | Robert R Jones | Family Medicine | 148 S Main St, Liberal, MO 64762-9314 | 2005-06-22 |
| 1982903563 | Inez Shields LLC | Counselor | 130 S Main St, Liberal, MO 64762-9314 | 2011-03-22 |
| 1407913833 | Judy M Parton | Family Medicine | 148 S Main St, Liberal, MO 64762-9314 | 2007-01-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255931374 | Justin Morton | Non-emergency Medical Transport (VAN) | 1002 S Washington Ave, Liberal, KS 67901-4604 | 2020-10-28 |
| 1649885294 | K&t LLC | Technician/Technologist | 412 N Kansas Ave, Liberal, KS 67901-3330 | 2020-09-10 |
| 1073124921 | St. Catherine Hospital | Obstetrics & Gynecology | 2132 N Kansas Ave Ste C, Liberal, KS 67901-2099 | 2020-08-13 |
| 1871101162 | Whitaker Fitness Corporation | Clinic/Center | 1530 N Western Ave, Liberal, KS 67901-2167 | 2020-07-22 |
| 1639787906 | Lonnie Whitaker | Dietary Manager | 1530 N Western Ave Apt 115, Liberal, KS 67901-2167 | 2020-07-22 |
| 1679181176 | Susan N Lukwago | Dietitian, Registered | 1330 N Cain Ave, Liberal, KS 67901-2317 | 2020-07-21 |
| 1740803576 | Emmanuel Garcia | Student in an Organized Health Care Education/Training Program | 2460 Ridge Rd, Liberal, KS 67901-2026 | 2020-05-27 |
| 1184269250 | Emanuel Fernando Serrano | Specialist/Technologist | 121 W Spruce St, Liberal, KS 67901-4043 | 2019-11-13 |
| 1992358378 | Lacy Smith | Nurse Practitioner | 504 N Kansas Ave Ste B1, Liberal, KS 67901-3346 | 2019-07-24 |
| 1053882563 | Regional Services | Nurse Practitioner | 205 N Payne St, Liberal, MO 64762-9263 | 2018-12-10 |
| Find all providers in LIBERAL | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, 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 Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972615649 | Rodd Galt Stockwell | Family Medicine | 2330 Kansas Ave, Suite 1, Liberal, KS 67901 | 2006-08-31 |
| 1427092600 | Lakshmanaraju Sidda Raju | Family Medicine | 2 Rock Island Rd, Liberal, KS 67901-3760 | 2006-06-16 |
| 1558314989 | Juvenal T. Jabel | Family Medicine | 400 Canna Ln, Liberal, KS 67901-4915 | 2006-05-18 |
| 1528034683 | Brandi L Boller | Family Medicine | 11 W Parkway Blvd, Liberal, KS 67901-2081 | 2006-02-27 |
| 1649276924 | Robert R Jones | Family Medicine | 148 S Main St, Liberal, MO 64762-9314 | 2005-06-22 |
| 1750770103 | United Methodist Western Kansas Mexican American Ministries, Inc. | Family Medicine | 121 W 3rd St, Liberal, KS 67901-3218 | 2015-01-22 |
| 1821351487 | Van Tuong Trinh | Family Medicine | 555 W 15th St, Ste A, Liberal, KS 67901-2467 | 2012-06-19 |
| 1700148442 | Liberal Family Medicine, LLC | Family Medicine | 305 W 15th St, Suite 103, Liberal, KS 67901 | 2012-06-08 |
| 1710261961 | Rama Krishna Reddy Chanda | Family Medicine | 315 W 15th St, Liberal, KS 67901-2455 | 2011-10-06 |
| 1669762167 | Rohitha Inturi | Family Medicine | 555 W 15th St, Suite A, Liberal, KS 67901-2467 | 2011-04-18 |
| Find all providers in LIBERAL | ||||
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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.