MIDWEST WOUND & WELLNESS LLC (NPI# 1215467733) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215467733 |
| Entity Type | Organization |
| Organization Name | MIDWEST WOUND & WELLNESS LLC |
| Practice Address |
555 W Pine St Farmington MO 63640-1439 |
| Practice Telephone | (573) 747-1510 |
| Practice Fax Number | 5737471512 |
| Mailing Telephone | 5737471510 |
| Mailing Fax Number | 5737471512 |
| Enumeration Date | 2017-06-18 |
| Last Update Date | 2017-06-18 |
| Authorized Official Name | KELLY M ROBERTS (OWNER) |
| Authorized Official Telephone | 5737471510 |
| Authorized Official Credential | FNP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 164W00000X | Licensed Practical Nurse | Nursing Service Providers | ||
| Y | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 1568912129 | 05 |
| Street Address |
555 W PINE ST |
| City | FARMINGTON |
| State | MO |
| Zip Code | 63640-1439 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235180688 | Stephanie A Moniz | Family Medicine | 555 W Pine St, Farmington, MO 63640-1439 | 2006-05-12 |
| 1013548403 | Misty Dawn Cain | Nurse Practitioner | 555 W Pine St, Farmington, MO 63640-1439 | 2020-02-04 |
| 1104476928 | Complex Healthcare of Farmington LLC | Emergency Medicine | 555 W Pine St, Farmington, MO 63640-1439 | 2019-09-13 |
| 1497231997 | Hope and Healing Counseling Center LLC | Social Worker | 555 W Pine St, Farmington, MO 63640-1439 | 2018-07-17 |
| 1659724946 | Lisa Mengwasser | Nurse Practitioner | 555 W Pine St, Farmington, MO 63640-1439 | 2016-07-21 |
| 1881854354 | Christina Ann Rariden | Nurse Practitioner | 555 W Pine St, Farmington, MO 63640-1439 | 2008-06-09 |
| 1528085156 | Guy D Roberts | Family Medicine | 555 W Pine St, Farmington, MO 63640-1426 | 2006-07-17 |
| 1154373017 | Paul S Moniz | Family Medicine | 555 W Pine St, Farmington, MO 63640-1439 | 2006-05-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316545254 | Brenda S Halton | Nurse Practitioner | 1010 West Columbia Street, Farmington, MO 63640 | 2020-10-13 |
| 1619519089 | Stacey Nicole Gillette | Counselor | 17885 Hart Pinkston Rd, Farmington, MO 63640 | 2019-10-17 |
| 1346890696 | Christopher Ryan Massey | Social Worker | 607 Pine St., Farmington, MO 63640 | 2019-09-18 |
| 1457909376 | Clarice Ogden | Social Worker | 203 South Washington Street, Farmington, MO 63640 | 2019-09-04 |
| 1861979718 | Clint Thebeau | In Home Supportive Care | 1276 W Liberty St, Farmington, MO 63640 | 2018-07-24 |
| 1023500600 | Lynn Machelle Knox | Counselor | 219 W Columbia St, Farmington, MO 63640 | 2018-05-31 |
| 1235620576 | Kim Bazzell | Registered Nurse | 1565 Ste. Genevieve Ave., Farmington, MO 63640 | 2018-05-22 |
| 1164919742 | Lincare Inc. | Durable Medical Equipment & Medical Supplies | 774 Market St, Farmington, MO 63640 | 2018-04-18 |
| 1184127813 | Michelle Lynette Corvallis | Chiropractor | 17 South Franklin St., Farmington, MO 63640 | 2018-03-08 |
| 1992206213 | Farmington Vision Care LLC | Optometrist | 110 E Harrison St, Farmington, MO 63640 | 2018-02-22 |
| Find all providers in zip 63640 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
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|---|---|---|---|---|
| 1811532500 | Alpha Wave Health Centers LLC | Clinic/Center | 10 Waterside Dr Ste 101, Farmington, CT 06032-3056 | 2019-11-17 |
| 1548569718 | Avon Allies LLC | Clinic/Center | 2 Bridgewater Rd Ste 100, Farmington, CT 06032-2269 | 2011-03-27 |
| 1780821512 | Sunrise Chiropractic LLC | Clinic/Center | 626 East Main St, Ste 3, Farmington, NM 87401-7432 | 2009-01-15 |
| 1578750626 | Marcus Seywerd Chiropractic Ltd | Clinic/Center | 16798 Embers Ave, Farmington, MN 55024-7310 | 2007-10-02 |
| 1083688345 | Family Chiropractic Center, Pa | Clinic/Center | 20700 Chippendale Ave W Ste 7, Farmington, MN 55024-8206 | 2006-02-14 |
| 1003112822 | Allina Health System | Clinic/Center | 21260 Chippendale Ave W, Farmington, MN 55024-1427 | 2011-01-27 |
| 1801106711 | Fairview Health Services | Clinic/Center | 19685 Pilot Knob Rd, Farmington, MN 55024-7238 | 2010-10-13 |
| 1528288693 | Long Chiropractic Inc | Clinic/Center | 307 E Karsch Blvd, Ste E, Farmington, MO 63640-1768 | 2007-04-30 |
| 1427120187 | Sunil G & Nilima P Chand | Clinic/Center | 1031 E Karsch Blvd, Farmington, MO 63640-3404 | 2006-11-15 |
| 1053407460 | Presbyterian Medical Services | Clinic/Center | 1001 W Broadway, Farmington, NM 87401-5638 | 2006-10-04 |
| Find all providers in FARMINGTON | ||||
| City | FARMINGTON |
| Zip Code | 63640 |
Please comment or provide details below to improve the information on MIDWEST WOUND & WELLNESS LLC.
| 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.