JUDYANN KRENNING (NPI# 1225058167) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225058167 |
| Entity Type | Individual |
| Full Name | JUDYANN KRENNING |
| Credential | M.D. |
| Practice Address |
600 Blues Lake Pkwy Rolla MO 65401-8022 |
| Practice Telephone | 5733648822 |
| Practice Fax Number | 5733415969 |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2020-03-10 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Y00000X | Otolaryngology | 114610 | MO | Allopathic & Osteopathic Physicians |
| N | 207YX0602X |
Otolaryngology Specialization: Otolaryngic Allergy |
114610 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 209748516 | 05 | |
| MO | HEALTHLINK | 383115 | 01 |
| MO | RAILROAD MEDICARE | P00071667 | 01 |
| MO | BLUE CROSS BLUE SHIELD | 3347A1 | 01 |
| Street Address |
600 BLUES LAKE PKWY |
| City | ROLLA |
| State | MO |
| Zip Code | 65401-8022 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841282860 | Lowell R Fisher | Surgery | 600 Blues Lake Pkwy, Rolla, MO 65401-8022 | 2005-08-16 |
| 1265952295 | Rachel Ann Feeler | Nurse Practitioner | 600 Blues Lake Pkwy, Rolla, MO 65401-8022 | 2017-06-21 |
| 1497285159 | Candace Kay Chafton | Nurse Practitioner | 600 Blues Lake Pkwy, Rolla, MO 65401-8022 | 2017-06-15 |
| 1871949461 | Anaid Hernandez-sanchez | Internal Medicine | 600 Blues Lake Pkwy, Rolla, MO 65401-8022 | 2016-05-12 |
| 1629460878 | Leah Kathleen Bond | Clinical Nurse Specialist | 600 Blues Lake Pkwy, Rolla, MO 65401-8022 | 2015-02-25 |
| 1811330806 | Cory L.s. Offutt | Family Medicine | 600 Blues Lake Pkwy, Rolla, MO 65401 | 2013-04-09 |
| 1043573462 | Lynne Cary Schenk | Audiologist | 600 Blues Lake Pkwy, Rolla, MO 65401-8022 | 2012-06-20 |
| 1821362088 | Matthew Warren Hurley | Family Medicine | 600 Blues Lake Pkwy, Rolla, MO 65401-8022 | 2012-03-05 |
| 1497064398 | Catherine Helen Zwintscher | Physician Assistant | 600 Blues Lake Pkwy, Rolla, MO 65401-8022 | 2010-09-27 |
| 1053638577 | Jennifer Lynn Bremer | Physician Assistant | 600 Blues Lake Pkwy, Rolla, MO 65401-8022 | 2010-04-23 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639645591 | Samantha Jo Mitchell | Pharmacist | 1375 E 10th St Suite B, Rolla, MO 65401 | 2018-10-18 |
| 1427567726 | Gerry Wade Funkhouser Jr. | Counselor | 103 W 10th St, Rolla, MO 65401 | 2017-09-29 |
| 1366967960 | Shana Hintz Wisniewski | Social Worker | 1000 W. 10th St., Rolla, MO 65401 | 2017-08-04 |
| 1174066559 | Tabitha Hundt | Counselor | 1011 Cypress Dr, Rolla, MO 65401 | 2016-12-02 |
| 1841742855 | Alpha Assisted Living LLC | Assisted Living Facility | 13450 Cr 7040, 803 E 12th St, Rolla, MO 65401 | 2016-10-26 |
| 1275916884 | Elizabeth Zersen | Occupational Therapist | 2053 Vienna Rd, Rolla, MO 65401 | 2015-06-30 |
| 1386047025 | Becky L Witham | Nurse Practitioner | 1060 W 10th Street, Rolla, MO 65401 | 2014-10-08 |
| 1114326121 | Summer Adey | Licensed Practical Nurse | 13750 State Route F, Rolla, MO 65401 | 2014-08-14 |
| 1518303296 | Leaetta Mildred Gardner | Nursing Facility/Intermediate Care Facility | 13450 County Road 7040, Rolla, MO 65401 | 2013-05-21 |
| 1316282064 | Susan Peitz Gruener | Occupational Therapy Assistant | 1800 White Column Road, Rolla, MO 65401 | 2012-12-06 |
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| Taxonomy Code | 207Y00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise. |
| 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 Otolaryngology, 2007. http://www.aboto.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417117854 | Mary Straub Doellman | Otolaryngology | 600 Blues Lake Pkwy, Rolla, MO 65401-8022 | 2008-06-10 |
| 1942491212 | Pcrmc Medical Group Inc | Otolaryngology | 1501 E 10th St, Suite B, Rolla, MO 65401-3696 | 2007-08-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205308871 | Head and Neck Surgical Associates of Lees Summit LLC | Otolaryngology | 3340 Ne Ralph Powell Rd, Lees Summit, MO 64064-2368 | 2018-12-20 |
| 1811480601 | Omar Ahmad Karadaghy | Otolaryngology | 600 E 8th St Apt 10s, Kansas City, MO 64106-1622 | 2018-06-07 |
| 1003337809 | Andrew John Vanbruggen | Otolaryngology | 1031 Mcintosh Cir, Joplin, MO 64804-3643 | 2017-06-30 |
| 1972043107 | Robert Christopher Loynd | Otolaryngology | 301 N. 2nd Street, St. Charles, MO 63301 | 2017-03-07 |
| 1649621921 | Zachary Farhood | Otolaryngology | 3635 Vista Ave, 6fdt, St. Louis, MO 63110 | 2016-06-28 |
| 1538510961 | Haley Nicole Bray | Otolaryngology | 3635 Vista Ave # 6dt, Saint Louis, MO 63110-2539 | 2016-06-27 |
| 1407207319 | Jesse Schmid | Otolaryngology | One Hosital Dr Ma314, Columbia, MO 65212 | 2016-06-22 |
| 1013304914 | Andrea Lee Hanick | Otolaryngology | Facial Plastic Surgery Center, 1044 North Mason Road, Mob4, Suite L10, Creve Coeur, MO 63141 | 2015-04-20 |
| 1023419405 | Arya W Namin | Otolaryngology | One Hospital Dr Ma314, Columbia, MO 65212 | 2014-09-04 |
| 1740689181 | David Sherman | Otolaryngology | 8350 State Route 30, Dittmer, MO 63023-1909 | 2014-08-21 |
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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.