DR. LEONID SHUNYAKOV (NPI# 1396709895) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396709895 |
| Entity Type | Individual |
| Full Name | DR. LEONID SHUNYAKOV |
| Credential | MD |
| 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 | 2006-04-13 |
| Last Update Date | 2020-02-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
04-31660 | KS | Allopathic & Osteopathic Physicians |
| N | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
2005002905 | MO | Allopathic & Osteopathic Physicians |
| N | 207RX0202X |
Internal Medicine Specialization: Medical Oncology |
04-31660 | KS | Allopathic & Osteopathic Physicians |
| Y | 207RX0202X |
Internal Medicine Specialization: Medical Oncology |
2005002905 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | MD LICENSE | 2005002905 | 01 |
| MO | 507606309 | 05 | |
| MO | DEA | BS9253814 | 01 |
| Street Address |
1501 N OAKLAND AVE |
| City | BOLIVAR |
| State | MO |
| Zip Code | 65613-3020 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 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 |
| 1316372154 | Central Care Pa | Non-Pharmacy Dispensing Site | 1501 N Oakland Ave, Bolivar, MO 65613-3020 | 2013-09-12 |
| 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 | 207RX0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Medical Oncology |
| An internist who specializes in the diagnosis and treatment of all types of cancer and other benign and malignant tumors. This specialist decides on and administers therapy for these malignancies as well as consults with surgeons and radiotherapists on other treatments for cancer. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source. 11/5/2007: corrected definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558670265 | Ken Kobayashi | Internal Medicine | 1412 Se 7th Pl, Lees Summit, MO 64063-8509 | 2010-09-29 |
| 1659546240 | Amandeep Kalra | Internal Medicine | 2330 E Meyer Blvd Ste 401, Kansas City, MO 64132-1132 | 2008-04-24 |
| 1255544680 | Mark Andrew Schroeder | Internal Medicine | 10 Barnes West Dr Ste 100, Ste 100, Saint Louis, MO 63141-6350 | 2007-05-08 |
| 1669573077 | Virginia M Herrmann | Internal Medicine | 11155 Dunn Rd Ste 101e, Ste 101e, Saint Louis, MO 63136-6148 | 2006-09-26 |
| 1962410829 | Timothy Patrick Rearden | Internal Medicine | 11125 Dunn Rd Ste 100, Ste 100, Saint Louis, MO 63136-6132 | 2006-08-04 |
| 1023034261 | Ramaswamy Govindan | Internal Medicine | 4921 Parkview Pl Ste 7a, Ste 7a, Saint Louis, MO 63110-1032 | 2006-07-14 |
| 1124081799 | Anna Roshal | Internal Medicine | 150 Entrance Way, Saint Peters, MO 63376-1645 | 2006-04-06 |
| 1639140288 | Shalina D. Gupta-burt | Internal Medicine | 2750 Clay Edwards Dr Lowr Level010, North Kansas City, MO 64116-3237 | 2006-01-31 |
| 1043292246 | Peter Westervelt | Internal Medicine | 4921 Parkview Pl Fl 7, 7th Fl, Saint Louis, MO 63110-1032 | 2005-11-15 |
| 1295727493 | Juan Daniel Cuevas | Internal Medicine | 3440 De Paul Ln Ste 201, Bridgeton, MO 63044-3546 | 2005-08-16 |
| 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.