MANDY R D'AGOSTINO (NPI# 1528384823) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528384823 |
| Entity Type | Individual |
| Full Name | MANDY R D'AGOSTINO |
| Other Name | MANDY R HOTMER |
| Credential | FNP-C |
| Practice Address |
2230 S Springfield Ave Ste H Bolivar MO 65613-9133 |
| Practice Telephone | 4177774800 |
| Practice Fax Number | 4173267300 |
| Mailing Telephone | 4177774800 |
| Mailing Fax Number | 4173267300 |
| Enumeration Date | 2010-04-12 |
| Last Update Date | 2015-08-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
20030009032 | MO | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
2230 S SPRINGFIELD AVE STE H |
| City | BOLIVAR |
| State | MO |
| Zip Code | 65613-9133 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083679104 | Oma L Shelton | Nurse Practitioner | 2230 S Springfield Ave, Suite H-j, Bolivar, MO 65613-9133 | 2006-04-20 |
| 1902255391 | Jocelyn Morey | Nurse Practitioner | 2230 S Springfield Ave, Suite H-j, Bolivar, MO 65613-9133 | 2016-06-07 |
| 1205267036 | Donie Harris-deaton | Nurse Practitioner | 2230 S Springfield Ave, Bolivar, MO 65613-9133 | 2013-12-04 |
| 1649504309 | Citizens Memorial Healthcare | Clinic/Center | 2230 S Springfield Ave, Suite H-j, Bolivar, MO 65613-9133 | 2009-09-29 |
| 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 | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457803363 | Brandy Yarnell | Nurse Practitioner | 2520 S Springfield Ave, Bolivar, MO 65613-9691 | 2016-10-26 |
| 1144636119 | Gregary Byers | Nurse Practitioner | 107 Tennessee St, Bolivar, TN 38008-1822 | 2014-07-10 |
| 1780908228 | Miracle Healthcare LLC | Nurse Practitioner | 649b W Mcneal St, Bolivar, TN 38008-2519 | 2010-03-25 |
| 1538273396 | Marceleen K. Powell | Nurse Practitioner | 1120 S Springfield Ave, Bolivar, MO 65613-2512 | 2006-08-18 |
| 1023066057 | Tammi L Ferguson | Nurse Practitioner | 1700 W Market St, Suite J, Bolivar, TN 38008-1653 | 2006-05-04 |
| 1083679104 | Oma L Shelton | Nurse Practitioner | 2230 S Springfield Ave, Suite H-j, Bolivar, MO 65613-9133 | 2006-04-20 |
| 1750999231 | Bethany Martin | Nurse Practitioner | 1501 N Oakland Ave, Bolivar, MO 65613-3020 | 2020-07-21 |
| 1104474741 | Kaylee Jaynelle Ankrom | Nurse Practitioner | 1300 N Oakland Ave, Bolivar, MO 65613-3018 | 2019-08-27 |
| 1164074175 | Courtney Marie Brummel | Nurse Practitioner | 1120 S Springfield Ave, Bolivar, MO 65613-2512 | 2019-07-10 |
| 1194211664 | Olivia Jenae Cumley | Nurse Practitioner | 1240 N Butterfield Rd, Bolivar, MO 65613-3016 | 2018-07-07 |
| 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.