CENTRAL CARE PA (NPI# 1316372154) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316372154 |
| Entity Type | Organization |
| Organization Name | CENTRAL CARE PA |
| Other Organization Name | CENTRAL CARE CANCER CENTER |
| Practice Address |
1501 N Oakland Ave Bolivar MO 65613-3020 |
| Mailing Address |
Po Box 256 Salina KS 67402-0256 |
| Practice Telephone | 4173267200 |
| Practice Fax Number | 4173267201 |
| Mailing Telephone | 7858230633 |
| Mailing Fax Number | 7858230658 |
| Enumeration Date | 2013-09-12 |
| Last Update Date | 2014-04-24 |
| Authorized Official Name | WENDY LEITH (DIRECTOR OF BILLING) |
| Authorized Official Telephone | 7858230633 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332900000X | Non-Pharmacy Dispensing Site | 002905 | MO | Suppliers |
| Other Name | Type Code |
|---|---|
| CENTRAL CARE CANCER CENTER | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487253050 | Central Care Pa | Clinic/Center | 3550 S 4th St Ste 282, Leavenworth, KS 66048-5160 | 2020-10-23 |
| 1558980474 | Central Care Pa | Clinic/Center | 8919 Parallel Pkwy Ste 326, Kansas City, KS 66112-1655 | 2020-04-10 |
| 1922340223 | Central Care Pa | Non-Pharmacy Dispensing Site | 204 Cleveland St, Great Bend, KS 67530-3563 | 2013-03-25 |
| Street Address |
1501 N OAKLAND AVE |
| City | BOLIVAR |
| State | MO |
| Zip Code | 65613-3020 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396709895 | Leonid Shunyakov | Internal Medicine | 1501 N Oakland Ave, Bolivar, MO 65613-3020 | 2006-04-13 |
| 1750999231 | Bethany Martin | Nurse Practitioner | 1501 N Oakland Ave, Bolivar, MO 65613-3020 | 2020-07-21 |
| 1912560038 | Bailey Rundel | Nurse Practitioner | 1501 N Oakland Ave, Bolivar, MO 65613-3020 | 2019-04-15 |
| 1598244618 | Chloe Jo Michelle Wingert | Physician Assistant | 1501 N Oakland Ave, Bolivar, MO 65613-3020 | 2018-08-09 |
| 1982103784 | Jennifer Michelle White | Physician Assistant | 1501 N Oakland Ave, Bolivar, MO 65613 | 2018-02-07 |
| 1710427612 | Citizens Memorial Healthcare Foundation | Durable Medical Equipment & Medical Supplies | 1501 N Oakland Ave, Bolivar, MO 65613-3020 | 2017-02-27 |
| 1417202425 | Anjali M Edson | Physician Assistant | 1501 N Oakland Ave, Bolivar, MO 65613-3020 | 2012-07-16 |
| 1942575527 | Central Care, Pa | Specialist | 1501 N Oakland Ave, Bolivar, MO 65613-3020 | 2012-03-15 |
| 1043366925 | Garry J Brown | Radiology | 1501 N Oakland Ave, Bolivar, MO 65613-3020 | 2007-01-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891301552 | Casablanca Care Center, LLC | Home Health | 524 S. Albany Avenue, Bolivar, MO 65613 | 2020-09-18 |
| 1669087045 | Revive Medical LLC | Durable Medical Equipment & Medical Supplies | 5000, S Scenic, Bolivar, MO 65613 | 2020-09-11 |
| 1669097119 | Melanie Nicole Beckham | Nurse Practitioner | 1100 South Springfield Ave, Suite B, Bolivar, MO 65613 | 2020-06-10 |
| 1932754744 | Caitlin M Williams | Specialist/Technologist | 1260 S Pike Avenue, Bolivar, MO 65613 | 2019-08-08 |
| 1073022406 | Jacquelyn Rose Kemnic | Dietitian, Registered | Heart Center, 1500 N Oakland Ave, Willard, MO 65613 | 2017-09-28 |
| 1164897161 | Ozarks Resource Group | Clinic/Center | 203 E. Broadway St., Bolivar, MO 65613 | 2015-12-02 |
| 1962895292 | Professional Christian Counseling | Counselor | 4888 S 139th Road, Bolivar, MO 65613 | 2015-03-11 |
| 1073916573 | Scott Leslie Dennis | Physician Assistant | 1500 North Oakland Ave, Citizens Memorial Hospital, Bolivar, MO 65613 | 2014-09-29 |
| 1053712109 | Citizens Memorial Hospital District | Pharmacy | 1301-b North Oakland, Bolivar, MO 65613 | 2014-09-09 |
| 1740680453 | Jamee M Stimpson | Occupational Therapist | 454 S. Main Avenue, Bolivar, MO 65613 | 2014-08-29 |
| Find all providers in zip 65613 | ||||
| Taxonomy Code | 332900000X |
| Grouping | Suppliers |
| Classification | Non-Pharmacy Dispensing Site |
| A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.) |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558909150 | Dedicated Missouri Holding, LLC | Non-Pharmacy Dispensing Site | 3649 Page Blvd, Saint Louis, MO 63113-3807 | 2019-12-13 |
| 1568945103 | Ficom | Non-Pharmacy Dispensing Site | 1308 North Glenstone Avenue, Springfield, MO 65802 | 2018-09-10 |
| 1033629761 | Cerner Health Connections, Inc | Non-Pharmacy Dispensing Site | 6601 Winchester Ave Ste 240, Kansas City, MO 64133-4657 | 2017-10-09 |
| 1861948697 | Midwest Health Group Convenient Care, LLC | Non-Pharmacy Dispensing Site | 123 N Mine La Motte St, Fredericktown, MO 63645-1201 | 2016-08-31 |
| 1114291515 | Burns & Mcdonnell | Non-Pharmacy Dispensing Site | 9400 Ward Pkwy, Kansas City, MO 64114-3319 | 2012-03-02 |
| 1811131956 | U.S. Optical | Non-Pharmacy Dispensing Site | 2346 S Campbell Ave, Springfield, MO 65807-2972 | 2009-04-20 |
| 1467661157 | Vitalsurge LLC | Non-Pharmacy Dispensing Site | 702 W 42nd St, Joplin, MO 64804-4564 | 2007-05-21 |
| 1477767259 | Ion Pharmaceuticals | Non-Pharmacy Dispensing Site | 2190 1st Capitol Dr, Saint Charles, MO 63301-5804 | 2007-05-10 |
| 1184703852 | Orthopedic Associates | Non-Pharmacy Dispensing Site | 1050 Des Peres Rd, Ste 100, Saint Louis, MO 63131-2042 | 2006-11-03 |
| 1790317402 | Dedicated Missouri Holding, LLC | Non-Pharmacy Dispensing Site | 175 N Oaks Plz, Saint Louis, MO 63121-2925 | 2020-02-10 |
| 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.