DR. OSAMEDE EDOKPOLO (NPI# 1326334459) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326334459 |
| Entity Type | Individual |
| Full Name | DR. OSAMEDE EDOKPOLO |
| Other Name | NMN NMN NMN |
| Credential | M.D |
| Practice Address |
620 E Monroe St Mexico MO 65265-2919 |
| Mailing Address |
Po Box 2580 Springfield MO 65801-2580 |
| Practice Telephone | 5735825000 |
| Mailing Telephone | 4178294620 |
| Enumeration Date | 2011-06-27 |
| Last Update Date | 2020-04-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
2013002773 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 1326334459 | 05 | |
| MO | TRICARE | 431560263 | 01 |
| MO | RR MCR | P01222578 | 01 |
| AR | 198983001 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1965 S Fremont Ave, Ste 330, Springfield, MO 658042201 | 4178208180 |
| Street Address |
620 E MONROE ST |
| City | MEXICO |
| State | MO |
| Zip Code | 65265-2919 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487659140 | Medical Imaging Associates of Mexico Mo | Radiology | 620 E Monroe St, Mexico, MO 65265-2919 | 2005-06-17 |
| 1053826727 | Ssm Audrain Health Care, Inc | Clinic/Center | 620 E Monroe St, Mexico, MO 65265-2919 | 2017-12-04 |
| 1225553621 | Zahir Abbas Sheth | Pharmacist | 620 E Monroe St, Mexico, MO 65265-2919 | 2017-08-07 |
| 1457712903 | Ssm Audrain Health Care, Inc | Psychiatry & Neurology | 620 E Monroe St, Mexico, MO 65265-2919 | 2016-03-11 |
| 1356712871 | Ssm Audrain Health Care, Inc. | Psychiatric Unit | 620 E Monroe St, Mexico, MO 65265-2919 | 2015-10-09 |
| 1457743148 | Audrain Physician Services LLC | Physician Assistant | 620 E Monroe St, Mexico, MO 65265-2919 | 2015-03-04 |
| 1407287378 | Michelle Hoeing | Dietitian, Registered | 620 E Monroe St, Mexico, MO 65265-2919 | 2013-12-03 |
| 1164706917 | Krystle Leigh Blunk | Dietitian, Registered | 620 E Monroe St, Mexico, MO 65265-2919 | 2011-09-28 |
| 1487987731 | Audrain Ambulance District | Ambulance | 620 E Monroe St, Mexico, MO 65265-2919 | 2009-09-17 |
| 1639311590 | Shellie Lynn Shaw | Dietitian, Registered | 620 E Monroe St, Mexico, MO 65265-2919 | 2009-03-24 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700448685 | Joanna Zidick Mcclarey | Specialist/Technologist | Rehabilitation Services, 711 E Jackson, Mexico, MO 65265 | 2019-07-01 |
| 1053858050 | Glenna Wilson | Social Worker | 2462 Southern Hls, Mexico, MO 65265 | 2017-01-27 |
| 1457601759 | Bruce Warren Garrett | Dentist | 626 Summit, Mexico, MO 65265 | 2012-09-13 |
| 1063775997 | Brandon Jay Glasgow | Physical Therapist | 2759 A S Clark, Mexico, MO 65265 | 2012-06-15 |
| 1407044548 | Missouri Central Physical Therapy, LLC | Specialist | 2759 A South Clark, Mexico, MO 65265 | 2007-10-12 |
| 1194925628 | Curators of The University of Missouri | Orthopaedic Surgery | 515 East Promenade, Mexico, MO 65265 | 2007-07-23 |
| 1740496199 | Scott Simmons | Family Medicine | 1000 Webster Street, Mexico, MO 65265 | 2007-05-15 |
| 1083741664 | Finck & Associates, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 17079 Audrain County Road 929, Mexico, MO 65265 | 2007-02-28 |
| 1417005893 | Matthew Eugene Hart | Emergency Medicine | 620 E Monroe Street, Mexico, MO 65265 | 2007-01-08 |
| 1144392051 | Corrine M Floyd | Massage Therapist | 713 East Jackson, Mexico, MO 65265 | 2006-11-15 |
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| Taxonomy Code | 2084P0800X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Psychiatry |
| A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174529648 | Zaki A Ajans | Psychiatry & Neurology | 400 E Liberty St, Mexico, MO 65265-2850 | 2005-06-21 |
| 1801243639 | East Central Missouri Behavioral Health Services, Inc | Psychiatry & Neurology | 340 Kelley Pkwy, Mexico, MO 65265-3811 | 2016-05-23 |
| 1457712903 | Ssm Audrain Health Care, Inc | Psychiatry & Neurology | 620 E Monroe St, Mexico, MO 65265-2919 | 2016-03-11 |
| 1003970849 | Ahsan Syed | Psychiatry & Neurology | 321 W Promenade St, Mexico, MO 65265-2719 | 2006-12-19 |
| 1083791792 | Sarmistha Bhalla | Psychiatry & Neurology | 321 W Promenade St, Mexico, MO 65265-2719 | 2006-11-01 |
| 1215978689 | Ahmed A Taranissi | Psychiatry & Neurology | 340 Kelley Pkwy, Mexico, MO 65265-3811 | 2006-06-09 |
| 1366428286 | Syed K Imam | Psychiatry & Neurology | 340 Kelley Pkwy, Mexico, MO 65265-3811 | 2005-12-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174142368 | Julie Lafferty Md, LLC | Psychiatry & Neurology | 655 Craig Rd Ste 336, Creve Coeur, MO 63141-7171 | 2020-04-08 |
| 1831738574 | Gina Rivera Sokolich | Psychiatry & Neurology | 930 Kehrs Mill Rd Ste 325-13, Ballwin, MO 63011-2403 | 2019-12-28 |
| 1750939864 | Brave, LLC | Psychiatry & Neurology | 2100 Forum Blvd Ste C-2, Columbia, MO 65203-5436 | 2019-09-01 |
| 1275193906 | New Day Psychiatric Services | Psychiatry & Neurology | 9904 Clayton Rd Ste 135, Saint Louis, MO 63124-1149 | 2019-06-14 |
| 1073171344 | Himangshu Rathinakumar | Psychiatry & Neurology | University of Missouri 1 Hospital Drive Dco67.00, Columbia, MO 65212-0001 | 2019-06-03 |
| 1285194613 | Mind Matters LLC | Psychiatry & Neurology | 3201 S Providence Rd Ste 202, Columbia, MO 65203-3622 | 2019-03-21 |
| 1336607282 | Qsr Psychiatric Solutions LLC | Psychiatry & Neurology | 12855 N 40 Dr Ste 350, Saint Louis, MO 63141-8669 | 2019-03-11 |
| 1093209124 | Restorative Brain Clinic, Inc | Psychiatry & Neurology | 1010 Carondelet Dr Ste 112, Kansas City, MO 64114-4821 | 2018-06-21 |
| 1790277374 | Taiye Oluyomi Popoola | Psychiatry & Neurology | 1 Hospital Dr # 67.00, Columbia, MO 65212-1000 | 2018-05-31 |
| 1548709603 | Whidbey Island Public Hospital District | Psychiatry & Neurology | 19203 Hazel Dell Rd, Higginsville, MO 64037-9162 | 2017-02-21 |
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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.