EVELYN D WALBERG (NPI# 1255996765) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255996765 |
| Entity Type | Individual |
| Full Name | EVELYN D WALBERG |
| Practice Address |
315 E Walnut St Ellington MO 63638-7943 |
| Practice Telephone | 5736632644 |
| Mailing Telephone | 5736632644 |
| Enumeration Date | 2019-05-09 |
| Last Update Date | 2019-05-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 146N00000X | Emergency Medical Technician, Basic | 65672 | MO | Emergency Medical Service Providers |
| Street Address |
315 E WALNUT ST |
| City | ELLINGTON |
| State | MO |
| Zip Code | 63638-7943 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518573286 | Deelaney Rae-ann Crocker | Behavior Technician | 315 E Walnut St, Ellington, MO 63638-7943 | 2020-09-18 |
| 1659902435 | Sarah Hill | Case Manager/Care Coordinator | 315 E Walnut St, Ellington, MO 63638-7943 | 2020-01-30 |
| 1700432259 | Victoria L Lacey | Behavior Technician | 315 E Walnut St, Ellington, MO 63638-7943 | 2019-08-12 |
| 1730450156 | Tasha Lynn Wisdom | Social Worker | 315 E Walnut St, Ellington, MO 63638 | 2012-01-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831398858 | Linda Lee Potter | Counselor | 125 A Temple St, Ellington, MO 63638 | 2007-07-11 |
| 1942424254 | Iris Fae Ross | Counselor | 110 N. Second St., Ellington, MO 63638 | 2007-04-11 |
| 1700916400 | Southern Reynolds Rii | Speech-Language Pathologist | One School Street, Ellington, MO 63638 | 2007-03-06 |
| 1467533604 | Sherilyn K Clark | Registered Nurse | 110 S. 2nd St., Ellington, MO 63638 | 2006-10-17 |
| 1770678211 | Big Springs Medical Association | Clinic/Center | 115 Walnut St, Ellington, MO 63638 | 2006-10-03 |
| 1376637728 | Jeanie Larue Mcclanahan | Dental Assistant | 115 Walnut St., Ellington, MO 63638 | 2006-10-02 |
| 1033420039 | Meagan Whitley Berry | Dental Hygienist | 115 Walnut St, Ellington, MO 63638 | 2010-06-24 |
| 1689814329 | Healthpro Physical Therapy LLC | Clinic/Center | 315 East Walnut, Ellington, MO 63638 | 2009-02-20 |
| 1992984173 | Dr. Stephen C. Waller, Dds, LLC | Dentist | 115 Walnut St, Ellington, MO 63638 | 2007-10-24 |
| 1770664906 | Stacey Keeney | Registered Nurse | 205 Walnut St., Ellington, MO 63638 | 2006-10-17 |
| Find all providers in zip 63638 | ||||
| Taxonomy Code | 146N00000X |
| Grouping | Emergency Medical Service Providers |
| Classification | Emergency Medical Technician, Basic |
| A Basic EMT is an individual trained and certified to perform basic life support treatment in medical emergencies based on individual state boards. |
| Notes: Sources: Tabers Medical Dictionary and Florida EMS Clearing House. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487192514 | Kami Parney | Emergency Medical Technician, Basic | 601 E 16th Street, Bothwell Regional Health Center, Sedalia, MO 65301 | 2017-02-09 |
| 1104260652 | Charles Justin Hangge | Emergency Medical Technician, Basic | 2862 Championship Blvd, Saint Louis, MO 63129-5269 | 2013-04-25 |
| 1588970479 | Brianne Marie Luck | Emergency Medical Technician, Basic | 2813 Kenborg Hls, Jefferson City, MO 65109-1002 | 2010-08-30 |
| 1932254828 | Kristan Erdmann | Emergency Medical Technician, Basic | 412 N Church St Apt 3, Fayette, MO 65248-1123 | 2007-01-24 |
| 1396742847 | Hermann Area Ambulance District | Emergency Medical Technician, Basic | 510 W 16th St, Hermann, MO 65041-1502 | 2005-06-30 |
| 1669005591 | Caleb Morlan | Emergency Medical Technician, Basic | 901 S National Ave # Prof160, Springfield, MO 65897-0027 | 2020-02-19 |
| 1740799576 | David Montijo | Emergency Medical Technician, Basic | 4430 Missouri Ave, Fort Leonard Wood, MO 65473-9098 | 2017-09-25 |
| 1063822211 | Chere Hellenbrand | Emergency Medical Technician, Basic | 102 N Sterling Ave, Sugar Creek, MO 64054-1207 | 2014-04-28 |
| 1952740748 | Mitchell J Mcginnis | Emergency Medical Technician, Basic | 904 Edmond St, Saint Joseph, MO 64501-2702 | 2013-06-14 |
| 1528206893 | Ryan Palmer | Emergency Medical Technician, Basic | 2727 Mcclelland Blvd, Joplin, MO 64804-1626 | 2009-01-25 |
| Find all providers with the same taxonomy | ||||
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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.