PARKCREST ORTHOPEDICS LLC (NPI# 1568860641) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568860641 |
| Entity Type | Organization |
| Organization Name | PARKCREST ORTHOPEDICS LLC |
| Practice Address |
508 W Pine St Farmington MO 63640-1426 |
| Mailing Address |
845 N New Ballas Ct Ste 130 Creve Coeur MO 63141-7169 |
| Practice Telephone | 3149971777 |
| Practice Fax Number | 3149976277 |
| Mailing Telephone | 3149971777 |
| Mailing Fax Number | 3149976277 |
| Enumeration Date | 2014-12-05 |
| Last Update Date | 2014-12-05 |
| Authorized Official Name | DR. JAMES EMANUEL (DOCTOR/OWNER) |
| Authorized Official Telephone | 3149971777 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207X00000X | Orthopaedic Surgery | 2011001614 | MO | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346509403 | Parkcrest Orthopedics LLC | Orthopaedic Surgery | 509 Hamacher St, Ste 202, Waterloo, IL 62298-1592 | 2012-05-10 |
| 1225210222 | Parkcrest Orthopedics LLC | Orthopaedic Surgery | 965 Mattox Dr, Sullivan, MO 63080-2365 | 2007-11-30 |
| Street Address |
508 W PINE ST |
| City | FARMINGTON |
| State | MO |
| Zip Code | 63640-1426 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316053028 | Gina Heberlie | Nurse Practitioner | 508 W Pine St, Farmington, MO 63640-1426 | 2006-08-23 |
| 1568088045 | Tanner Lorenz | Dentist | 508 W Pine St, Farmington, MO 63640-1426 | 2020-06-22 |
| 1922446384 | Great Mines Health Center | Clinic/Center | 508 W Pine St, Farmington, MO 63640-1426 | 2013-06-07 |
| 1760754386 | Midwest Health Group, LLC | Non-Pharmacy Dispensing Site | 508 W Pine St, Farmington, MO 63640-1426 | 2012-01-27 |
| 1356629430 | Christine A Herrington | Nurse Practitioner | 508 W Pine St, Farmington, MO 63640-1426 | 2011-07-24 |
| 1841584737 | Charles Justus Elkington | Dentist | 508 W Pine St, Farmington, MO 63640-1426 | 2011-06-08 |
| 1992884183 | Diane Marie Radosevich | Nurse Practitioner | 508 W Pine St, Farmington, MO 63640-1426 | 2006-11-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316545254 | Brenda S Halton | Nurse Practitioner | 1010 West Columbia Street, Farmington, MO 63640 | 2020-10-13 |
| 1619519089 | Stacey Nicole Gillette | Counselor | 17885 Hart Pinkston Rd, Farmington, MO 63640 | 2019-10-17 |
| 1346890696 | Christopher Ryan Massey | Social Worker | 607 Pine St., Farmington, MO 63640 | 2019-09-18 |
| 1457909376 | Clarice Ogden | Social Worker | 203 South Washington Street, Farmington, MO 63640 | 2019-09-04 |
| 1861979718 | Clint Thebeau | In Home Supportive Care | 1276 W Liberty St, Farmington, MO 63640 | 2018-07-24 |
| 1023500600 | Lynn Machelle Knox | Counselor | 219 W Columbia St, Farmington, MO 63640 | 2018-05-31 |
| 1235620576 | Kim Bazzell | Registered Nurse | 1565 Ste. Genevieve Ave., Farmington, MO 63640 | 2018-05-22 |
| 1164919742 | Lincare Inc. | Durable Medical Equipment & Medical Supplies | 774 Market St, Farmington, MO 63640 | 2018-04-18 |
| 1184127813 | Michelle Lynette Corvallis | Chiropractor | 17 South Franklin St., Farmington, MO 63640 | 2018-03-08 |
| 1992206213 | Farmington Vision Care LLC | Optometrist | 110 E Harrison St, Farmington, MO 63640 | 2018-02-22 |
| Find all providers in zip 63640 | ||||
| Taxonomy Code | 207X00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336151232 | James Lee Pace | Orthopaedic Surgery | 399 Farmington Ave Ste 300, Farmington, CT 06032-1979 | 2006-08-12 |
| 1487684882 | Joseph J Caldwell | Orthopaedic Surgery | 167 Livermore Falls Rd, Farmington, ME 04938-6241 | 2006-07-03 |
| 1912935461 | Victor M Brown | Orthopaedic Surgery | 1101 Weber Road, Suite203, Farmington, MO 63640 | 2006-06-30 |
| 1215980420 | Richard Lawrence Lawton | Orthopaedic Surgery | 2300 E 30th St Ste 101, Farmington, NM 87401-8990 | 2006-05-18 |
| 1801443387 | Berkbigler Orthopaedics and Sports Specialists LLC | Orthopaedic Surgery | 606 Maple Valley Dr, Farmington, MO 63640-1976 | 2019-08-20 |
| 1689168486 | Arthur Louis Kasimer-colon | Orthopaedic Surgery | 263 Farmington Ave, Farmington, CT 06030 | 2018-06-15 |
| 1154700854 | Stephen Brandon Luczak | Orthopaedic Surgery | 263 Farmington Ave., Farmington, CT 06030-4037 | 2015-05-27 |
| 1972915072 | Zachary Cavanaugh | Orthopaedic Surgery | 263 Farmington Ave, Marb Mc 4037, Farmington, CT 06032-1956 | 2014-05-22 |
| 1144664715 | Olga Solovyova | Orthopaedic Surgery | 263 Farmington Avenue, Farmington, CT 06030 | 2013-04-25 |
| 1043568249 | Orthopedic Associates of Hartford,pc | Orthopaedic Surgery | 399 Farmington Ave, Suite 110, Farmington, CT 06032-1936 | 2012-08-17 |
| Find all providers in FARMINGTON | ||||
| City | FARMINGTON |
| Zip Code | 63640 |
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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.