SIGNATURE MEDICAL GROUP, INC (NPI# 1396907614) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396907614 |
| Entity Type | Organization |
| Organization Name | SIGNATURE MEDICAL GROUP, INC |
| Practice Address |
1165 N Butterfield Rd Bolivar MO 65613-1056 |
| Mailing Address |
12639 Old Tesson Rd Suite 115 Saint Louis MO 63128-2786 |
| Practice Telephone | 4177778131 |
| Practice Fax Number | 4717778892 |
| Mailing Telephone | 3148490311 |
| Mailing Fax Number | 3148494423 |
| Enumeration Date | 2008-06-27 |
| Last Update Date | 2013-04-09 |
| Authorized Official Name | MR. JAN VEST (CEO) |
| Authorized Official Telephone | 3148490311 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235430851 | Signature Medical Group, Inc | Family Medicine | 2010 S Arlington Heights Rd Ste 110, Arlington Heights, IL 60005-4100 | 2010-11-12 |
| 1255513784 | Signature Medical Group, Inc | Durable Medical Equipment & Medical Supplies | 12777 De Paul Drive, Suite 305, Bridgeton, MO 63044 | 2007-11-27 |
| 1992998256 | Signature Medical Group, Inc | Durable Medical Equipment & Medical Supplies | 20 Progress Point Parkway, Suite 106, O Fallon, MO 63368 | 2007-08-21 |
| 1609269919 | Signature Medical Group, Inc | Durable Medical Equipment & Medical Supplies | 5301 Veterans Memorial Pkwy, Suite 104, Saint Peters, MO 63376-2298 | 2015-03-11 |
| 1073904769 | Signature Medical Group, Inc | Durable Medical Equipment & Medical Supplies | 9323 Phoenix Village Pkwy, O Fallon, MO 63368-4281 | 2015-02-17 |
| 1023435534 | Signature Medical Group, Inc | Durable Medical Equipment & Medical Supplies | 7345 Watson Rd, Suite Ll3, Saint Louis, MO 63119-4405 | 2014-03-21 |
| 1255477469 | Signature Medical Group, Inc | Durable Medical Equipment & Medical Supplies | 1027 Bellevue Ave, Suite 25, Saint Louis, MO 63117-1851 | 2007-01-29 |
| 1124164942 | Signature Medical Group, Inc | Durable Medical Equipment & Medical Supplies | 621 S New Ballas Rd, Suite 63b, Saint Louis, MO 63141-8232 | 2007-01-29 |
| 1649201864 | Signature Medical Group, Inc | Durable Medical Equipment & Medical Supplies | 12639 Old Tesson Rd, Suite 115, Saint Louis, MO 63128-2786 | 2006-07-05 |
| 1871542761 | Signature Medical Group, Inc | Allergy & Immunology | 12639 Old Tesson Rd, Suite 115, Saint Louis, MO 63128-2786 | 2006-05-08 |
| Street Address |
1165 N BUTTERFIELD RD |
| City | BOLIVAR |
| State | MO |
| Zip Code | 65613-1056 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861448854 | Dana M Meents | Obstetrics & Gynecology | 1165 N Butterfield Rd, Bolivar, MO 65613-1056 | 2006-05-25 |
| 1720402175 | Bolivar Ob/gyn | Obstetrics & Gynecology | 1165 N Butterfield Rd, Suite B, Bolivar, MO 65613-1056 | 2014-02-05 |
| 1508979402 | Maida Patricia Baugh | Pediatrics | 1165 N Butterfield Rd, Bolivar, MO 65613-1056 | 2006-08-16 |
| 1366481434 | Charles K Burlison | Obstetrics & Gynecology | 1165 N Butterfield Rd, Bolivar, MO 65613-1056 | 2006-06-05 |
| 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 | 332B00000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient’s use in the home and that are usable for an extended period of time. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275601353 | Dan Mchans Store Inc | Durable Medical Equipment & Medical Supplies | 103 E Broadway St, Bolivar, MO 65613-1621 | 2006-11-30 |
| 1033217062 | Family Pharmacy of Missouri LLC | Durable Medical Equipment & Medical Supplies | 1326 W Broadway St, Bolivar, MO 65613-1815 | 2006-09-21 |
| 1881611069 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 1604 W Market St, Bolivar, TN 38008-1536 | 2006-07-16 |
| 1881611200 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 2451 S Springfield Ave, Bolivar, MO 65613-9123 | 2006-07-16 |
| 1285605477 | Citizens Memorial Health Care Foundation | Durable Medical Equipment & Medical Supplies | 1915 S Springfield Ave, Bolivar, MO 65613-9684 | 2006-01-27 |
| 1578042164 | Smith Management Services, LLC | Durable Medical Equipment & Medical Supplies | 1326 W Broadway St, Bolivar, MO 65613-1815 | 2018-08-14 |
| 1710427612 | Citizens Memorial Healthcare Foundation | Durable Medical Equipment & Medical Supplies | 1501 N Oakland Ave, Bolivar, MO 65613-3020 | 2017-02-27 |
| 1538540406 | Summers Pharmacy of Bolivar, Inc | Durable Medical Equipment & Medical Supplies | 2000 S Springfield Ave, Bolivar, MO 65613-9654 | 2015-06-16 |
| 1619303823 | Citizens Memorial Hospital District | Durable Medical Equipment & Medical Supplies | 1500 N Oakland Ave, Bolivar, MO 65613-3011 | 2013-09-19 |
| 1861767568 | Citizens Memorial Health Care Foundation | Durable Medical Equipment & Medical Supplies | 1100 S Springfield Ave, Bolivar, MO 65613-2512 | 2012-03-13 |
| Find all providers in BOLIVAR | ||||
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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.