MID-MISSOURI INTERNAL MEDICINE INC (NPI# 1508840901) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508840901 |
| Entity Type | Organization |
| Organization Name | MID-MISSOURI INTERNAL MEDICINE INC |
| Practice Address |
1050 W 10th St Ste 550 Rolla MO 65401-2905 |
| Practice Telephone | 5733647545 |
| Practice Fax Number | 5733683672 |
| Mailing Telephone | 5733647545 |
| Mailing Fax Number | 5733683672 |
| Enumeration Date | 2005-11-30 |
| Last Update Date | 2008-05-12 |
| Authorized Official Name | TRISH LEANNE KLEIN (OFFICE MANAGER) |
| Authorized Official Telephone | 5733647545 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 34425 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | UNITED HEALTHCARE | 1436867 | 01 |
| MO | 504474602 | 05 | |
| MO | PROVIDER NPI | 1013100866 | 01 |
| MO | BLUE CROSS BLUE SHIELD | 123495 | 01 |
| MO | MEDICARE TRAVELERS | DG8365 | 01 |
| Street Address |
1050 W 10TH ST STE 550 |
| City | ROLLA |
| State | MO |
| Zip Code | 65401-2905 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639645591 | Samantha Jo Mitchell | Pharmacist | 1375 E 10th St Suite B, Rolla, MO 65401 | 2018-10-18 |
| 1427567726 | Gerry Wade Funkhouser Jr. | Counselor | 103 W 10th St, Rolla, MO 65401 | 2017-09-29 |
| 1366967960 | Shana Hintz Wisniewski | Social Worker | 1000 W. 10th St., Rolla, MO 65401 | 2017-08-04 |
| 1174066559 | Tabitha Hundt | Counselor | 1011 Cypress Dr, Rolla, MO 65401 | 2016-12-02 |
| 1841742855 | Alpha Assisted Living LLC | Assisted Living Facility | 13450 Cr 7040, 803 E 12th St, Rolla, MO 65401 | 2016-10-26 |
| 1275916884 | Elizabeth Zersen | Occupational Therapist | 2053 Vienna Rd, Rolla, MO 65401 | 2015-06-30 |
| 1386047025 | Becky L Witham | Nurse Practitioner | 1060 W 10th Street, Rolla, MO 65401 | 2014-10-08 |
| 1114326121 | Summer Adey | Licensed Practical Nurse | 13750 State Route F, Rolla, MO 65401 | 2014-08-14 |
| 1518303296 | Leaetta Mildred Gardner | Nursing Facility/Intermediate Care Facility | 13450 County Road 7040, Rolla, MO 65401 | 2013-05-21 |
| 1316282064 | Susan Peitz Gruener | Occupational Therapy Assistant | 1800 White Column Road, Rolla, MO 65401 | 2012-12-06 |
| Find all providers in zip 65401 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699043265 | Ruth Stoecker | Internal Medicine | 1110 Soest Road, Rolla, MO 65401-3781 | 2011-12-09 |
| 1790895597 | Syed Z Zahoor Ul Mueen | Internal Medicine | 1050 W 10th St Ste 430, Rolla, MO 65401-2905 | 2006-08-30 |
| 1457302937 | Oluyomi O Olusanya | Internal Medicine | 1060 S Bishop Ave, Rolla, MO 65401-4465 | 2006-05-12 |
| 1518962570 | Donald James Mcmullin | Internal Medicine | 1050 W 10th St, Rolla, MO 65401 | 2005-06-16 |
| 1124561592 | Javier Amhed De La Cruz Martinez | Internal Medicine | 1000 W 10th St, Rolla, MO 65401-2905 | 2016-12-02 |
| 1922457712 | Madhura G Joag | Internal Medicine | 1605 Martin Springs Dr, Rolla, MO 65401-2982 | 2016-06-13 |
| 1871949461 | Anaid Hernandez-sanchez | Internal Medicine | 600 Blues Lake Pkwy, Rolla, MO 65401-8022 | 2016-05-12 |
| 1053746156 | Denis Douglas Asiimwe | Internal Medicine | 1000 W 10th St, Internal Medicine Department, Rolla, MO 65401 | 2013-09-08 |
| 1689939993 | Thomas Guerrero-garcia | Internal Medicine | 1060 W 10th St, Rolla, MO 65401-2905 | 2012-07-12 |
| 1992089619 | Abdalla Oun | Internal Medicine | 1000 W 10th St, Rolla, MO 65401 | 2011-09-29 |
| Find all providers in ROLLA | ||||
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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.