KELLI BROCKMAN (NPI# 1477818599) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477818599 |
| Entity Type | Individual |
| Full Name | KELLI BROCKMAN |
| Practice Address |
255 Boderman Bloomsdale MO 63627-9099 |
| Practice Telephone | 3096213405 |
| Mailing Telephone | 3096213405 |
| Enumeration Date | 2012-07-05 |
| Last Update Date | 2016-02-29 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 2015011883 | MO | Allopathic & Osteopathic Physicians |
| Street Address |
255 BODERMAN |
| City | BLOOMSDALE |
| State | MO |
| Zip Code | 63627-9099 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710974019 | Theresa A Cavins | Surgery | 255 Boderman, Bloomsdale, MO 63627-9099 | 2005-10-02 |
| 1669989786 | Jill Mccalister | Pharmacist | 255 Boderman, Bloomsdale, MO 63627-9099 | 2018-01-10 |
| 1144730615 | Jacqueline M Wolk | Nurse Practitioner | 255 Boderman, Bloomsdale, MO 63627-9099 | 2017-10-10 |
| 1437668969 | Lisa Engle | Nurse Practitioner | 255 Boderman, Bloomsdale, MO 63627-9099 | 2017-09-27 |
| 1538616362 | Melissa Ann Naeger | Nurse Practitioner | 255 Boderman, Bloomsdale, MO 63627-9099 | 2016-09-09 |
| 1609243013 | Cristella Patricia Torres | Family Medicine | 255 Boderman, Bloomsdale, MO 63627 | 2015-09-01 |
| 1063813046 | Regine Politte | Nurse Practitioner | 255 Boderman, Bloomsdale, MO 63627-9099 | 2014-09-10 |
| 1699028415 | Ste Genevieve County Memorial Hospital | Pharmacy | 255 Boderman, Suite 1e, Bloomsdale, MO 63627 | 2012-10-17 |
| 1194075200 | Ste. Genevieve County Memorial Hospital | General Practice | 255 Boderman, Suite 2a, Bloomsdale, MO 63670 | 2012-09-17 |
| 1477803583 | Ste Genevieve County Memorial Hospital | Surgery | 255 Boderman, Suite 1b, Bloomsdale, MO 63627 | 2012-09-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861745689 | Jessica Drury | Pharmacist | 255 Boderman Lane, Suite 1e, Bloomsdale, MO 63627 | 2012-10-17 |
| 1710239496 | Kimberly L Browne | Registered Nurse | 255 Boderman Road, Bloomsdale, MO 63627 | 2012-10-05 |
| 1558544239 | Heather Ladonn Huck | Occupational Therapist | 63 Meyer Lane, Bloomsdale, MO 63627 | 2007-12-17 |
| 1336328087 | Drury Chiropractic and Family Wellness LLC | Chiropractor | 92 Mill Hill Rd, Bloomsdale, MO 63627 | 2007-10-30 |
| 1316144652 | Donna Kay Nicholson | Counselor | 8984 State Rt. Dd, Bloomsdale, MO 63627 | 2007-06-29 |
| 1225181159 | Jodi M. Naeger | Speech-Language Pathologist | 6279 Highway 61, Bloomsdale, MO 63627-8904 | 2007-01-22 |
| 1932714748 | Adam Paul Schwent | Physical Therapist | 9748 E Cottonwood Ln, Bloomsdale, MO 63627-8955 | 2020-09-09 |
| 1124448386 | Tina Howe | Counselor | 8699 Jackson School Rd, Bloomsdale, MO 63627-9038 | 2014-04-25 |
| 1932663648 | Maria Rose Hermann | Student in an Organized Health Care Education/Training Program | 11671 State Route Y, Bloomsdale, MO 63627-9068 | 2019-01-27 |
| 1871841395 | Ste Genevieve County Memorial Hospital | Clinic/Center | 255 Boderman Dr, Bloomsdale, MO 63627-9099 | 2012-08-15 |
| Find all providers in zip 63627 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114537222 | Natalie Joan Wilson | Pediatrics | 1463 Us Hwy 61, Suite C, Festus, MO 63028-6302 | 2020-08-04 |
| 1538786413 | Melissa An | Pediatrics | 1 Childrens Pl Ste 3s36, Saint Louis, MO 63110-1002 | 2020-06-26 |
| 1033731500 | Jessica N Zeiss | Pediatrics | 981 Highway K, Rhineland, MO 65069-2214 | 2020-05-07 |
| 1538795547 | Virtualnicu | Pediatrics | 10 Warridge Dr, Saint Louis, MO 63124-1166 | 2020-03-21 |
| 1811528656 | Children's Mercy-cockerell and Mcintosh Pediatrics, Inc | Pediatrics | 205 Nw R D Mize Rd Ste 304, Blue Springs, MO 64014-2520 | 2020-01-30 |
| 1134780430 | Jane Reardon | Pediatrics | 8140 Ward Pkwy Ste 275, Kansas City, MO 64114-2032 | 2019-06-26 |
| 1174082887 | Kristen Steinmeyer | Pediatrics | 714 Peace Haven Ct, Saint Louis, MO 63125-5404 | 2019-03-13 |
| 1023574365 | Saint Francis Medical Center | Pediatrics | 2210 Barron Rd Ste 120, Poplar Bluff, MO 63901-1908 | 2019-02-12 |
| 1215402011 | Ayse Bahar Budan Caliskan | Pediatrics | Washington University, St. Louis Children's Hospital, One Children's Place, 4n1, St. Louis, MO 63110-1002 | 2018-10-08 |
| 1336634500 | Martin K Mwangi | Pediatrics | 1 Childrens Place, 3s34, St. Louis, M, MO 63110 | 2018-06-28 |
| Find all providers with the same taxonomy | ||||
| City | BLOOMSDALE |
| Zip Code | 63627 |
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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.