BOBBY VITAYA ENKVETCHAKUL (NPI# 1487764882) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487764882 |
| Entity Type | Individual |
| Full Name | BOBBY VITAYA ENKVETCHAKUL |
| Credential | M.D. |
| Practice Address |
851 E 5th St Suite 152 Washington MO 63090-3135 |
| Mailing Address |
Po Box 1275 851 E 5th St. Suite 152 Washington MO 63090-8275 |
| Practice Telephone | 6362390735 |
| Practice Fax Number | 6362390907 |
| Mailing Telephone | 6362390735 |
| Mailing Fax Number | 6362390907 |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QX0100X |
Clinic/Center Specialization: Occupational Medicine |
MD113081 MO | MO | Ambulatory Health Care Facilities |
| Street Address |
851 E 5TH ST SUITE 152 |
| City | WASHINGTON |
| State | MO |
| Zip Code | 63090-3135 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790781268 | Michelle L Beumer | Pediatrics | 851 E 5th St, Ste 312, Washington, MO 63090-3130 | 2005-06-21 |
| 1669018602 | Sheila Ann Buesking | Nurse Practitioner | 851 E 5th St, Washington, MO 63090-3135 | 2019-11-25 |
| 1437794898 | Amanda Leanna Martin | Dietitian, Registered | 851 E 5th St, Washington, MO 63090-3135 | 2019-11-08 |
| 1609303460 | Minami Ohta | Counselor | 851 E 5th St, Suite 200, Washington, MO 63090-3135 | 2017-05-11 |
| 1427413467 | Alison Hoglan | Social Worker | 851 E 5th St, Suite 200, Washington, MO 63090-3135 | 2015-12-17 |
| 1760857833 | Jillian Poretti | Dietitian, Registered | 851 E 5th St, Suite 226, Washington, MO 63090-3135 | 2015-12-01 |
| 1942636980 | Mercy Clinic Pain Management, LLC | Anesthesiology | 851 E 5th St, Suite 144, Washington, MO 63090-3135 | 2013-09-23 |
| 1467792523 | Marie Bernice Sander | Nurse Practitioner | 851 E 5th St, Suite 208, Washington, MO 63090-3135 | 2013-02-26 |
| 1215299482 | Deborah Bernice Beste | Nurse Practitioner | 851 E 5th St, Suite 200, Washington, MO 63090-3135 | 2012-06-13 |
| 1801154489 | Feet for Life Centers Inc PC | Podiatrist | 851 E 5th St, #228, Washington, MO 63090-3135 | 2012-05-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831798792 | Alicia Caroline Baker | Nurse Practitioner | 1070 W 7th St, Washington, MO 63090 | 2020-10-21 |
| 1962975839 | Jennifer Biermann | Pharmacist | 801 E 5th Street, Washington, MO 63090 | 2019-01-03 |
| 1487199733 | Kristen Elaine Cleavelin | Registered Nurse | Mercy Convenient Care, 901 Patients First Drive, Washington, MO 63090 | 2016-12-22 |
| 1699146712 | Washington Community Counseling Center | Community/Behavioral Health | 421 W. 5th Street, Suite 110, Washington, MO 63090 | 2015-10-15 |
| 1598002024 | Americare At Vicotrian Manor of Washington, LLC | Assisted Living Facility | 2701 Rabbit Trail Dr, Washington, MO 63090 | 2013-01-03 |
| 1578824116 | Rhonda Ann Pepmiller | Nurse Practitioner | 851 E 5th St Ste 309, Washington, MO 63090 | 2012-05-30 |
| 1932486032 | Julie Joanne Lynch | Pharmacist | 890 Country Corners, Washington, MO 63090 | 2011-11-03 |
| 1043590839 | Laurie Elizabeth Bryson | Counselor | 102 Elm Street, Suite 204, Washington, MO 63090 | 2011-08-24 |
| 1164737490 | Mohan Mallikarjuna Edupuganti | Internal Medicine | 901 Patients First Dr Ste 2500, Washington, MO 63090 | 2010-08-11 |
| 1154640225 | Nicholas W Frederickson | Internal Medicine | 901 Patients First Drive Suite 3300, Washington, MO 63090 | 2010-05-27 |
| Find all providers in zip 63090 | ||||
| Taxonomy Code | 261QX0100X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Occupational Medicine |
| Definition to come... |
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|---|---|---|---|---|
| 1558820787 | Neurosuite LLC | Clinic/Center | 1220 Holbrook Ter Ne Apt B3, Washington, DC 20002-2712 | 2019-03-18 |
| 1639290398 | Northside Medical Services Corporation | Clinic/Center | 4121 Minnesota Ave Ne, Washington, DC 20019-3572 | 2007-04-02 |
| 1679087365 | Providence Health Services, Inc | Clinic/Center | 1150 Varnum St Ne, Washington, DC 20017-2104 | 2017-11-17 |
| 1619315009 | Gl Medical, Inc. | Clinic/Center | 3300 Pennsylvania Ave Se, Washington, DC 20020-2408 | 2013-06-07 |
| 1821301904 | Immaculate Medical Services LLC | Clinic/Center | 106 Irving St Nw, Suite 308 South, Washington, DC 20010-2927 | 2010-07-19 |
| 1356660773 | Northside Medical Services Corporation | Clinic/Center | 4121 Minnesota Ave Ne, Washington, DC 20019-3572 | 2010-05-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255823720 | Meritas Health Corporation | Clinic/Center | 1805 Nw Platte Rd Ste 110, Kansas City, MO 64150-7500 | 2018-05-31 |
| 1568848976 | Hallmark Cards, Inc. | Clinic/Center | 2501 Mcgee St, Md #185, Kansas City, MO 64108-2615 | 2015-08-07 |
| 1619219136 | Occupational Health Centers of Kansas Pa | Clinic/Center | 1794 Zumbehl Rd, Saint Charles, MO 63303-2759 | 2013-03-22 |
| 1609128446 | Workplace Medical Center, LLC | Clinic/Center | 4830 E 32nd St, Suite #5, Joplin, MO 64804-4463 | 2012-10-03 |
| 1740430677 | Dr Gils Immediate Care | Clinic/Center | 3000 E Division, Suite E, Springfield, MO 65802 | 2008-09-29 |
| 1063603140 | The Work Center, Inc | Clinic/Center | 4004 Peach Ct, Suite H, Columbia, MO 65203-3800 | 2007-08-05 |
| 1821294877 | Skaggs Community Health Center | Clinic/Center | 121 Cahill Road, Suite 201, Branson, MO 65616 | 2007-06-26 |
| 1093826166 | Metropolitan Occupational Medicine P.C. | Clinic/Center | 13613 Lakefront Dr, Earth City, MO 63045-1404 | 2006-08-31 |
| 1811905904 | Good Shepherd Care Center | Clinic/Center | 1101 W Clay Rd, Versailles, MO 65084-9314 | 2006-08-04 |
| 1366949430 | Occupational Health Centers of Kansas Pa | Clinic/Center | 1650 Broadway Blvd, Kansas City, MO 64108-1208 | 2018-04-06 |
| Find all providers with the same taxonomy | ||||
| City | WASHINGTON |
| Zip Code | 63090 |
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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.