COLUMBIA COMPREHENSIVE CANCER CARE CLINIC (NPI# 1568886273) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568886273 |
| Entity Type | Organization |
| Organization Name | COLUMBIA COMPREHENSIVE CANCER CARE CLINIC |
| Practice Address |
500 N Keene St Suite 202 Columbia MO 65201-8104 |
| Practice Telephone | 5734426800 |
| Practice Fax Number | 5734494943 |
| Mailing Telephone | 5734426800 |
| Mailing Fax Number | 5734494943 |
| Enumeration Date | 2014-02-17 |
| Last Update Date | 2014-02-17 |
| Authorized Official Name | DR. ALI KHOJASTEH (OWNER) |
| Authorized Official Telephone | 5734426800 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
R9764 | MO | Allopathic & Osteopathic Physicians |
| Street Address |
500 N KEENE ST SUITE 202 |
| City | COLUMBIA |
| State | MO |
| Zip Code | 65201-8104 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467458943 | Allan James Shapiro | Pediatrics | 500 N Keene St, Ste 207, Columbia, MO 65201-8105 | 2005-06-21 |
| 1396296331 | Mary Bunch | Nurse Practitioner | 500 N Keene St, Columbia, MO 65201 | 2016-10-14 |
| 1831586247 | Dr Ali Khojasteh Medexcellence LLC | Specialist | 500 N Keene St, Suite 202, Columbia, MO 65201-8104 | 2015-04-23 |
| 1922448430 | Angel Jaime Enciso | Obstetrics & Gynecology | 500 N Keene St, Suite 400, Columbia, MO 65201-8104 | 2013-06-28 |
| 1710243324 | Denicia Shane Dwarica | Obstetrics & Gynecology | 500 N Keene St, Columbia, MO 65201-8105 | 2012-04-09 |
| 1952672388 | Melissa Ann Liepins Masek | Optometrist | 500 N Keene St, Suite 103, Columbia, MO 65201-8104 | 2012-01-17 |
| 1447547989 | Amy A Zguta Md LLC | Ophthalmology | 500 N Keene St, Suite 101, Columbia, MO 65201-8104 | 2011-07-05 |
| 1932354750 | Julie Ann Starr | Nurse Practitioner | 500 N Keene St, Columbia, MO 65201-8104 | 2008-11-20 |
| 1376700823 | Amy Ajans Zguta | Ophthalmology | 500 N Keene St, Ste 101, Columbia, MO 65201-8104 | 2008-05-21 |
| 1962602672 | Kathy Lynn Timms | Pathology | 500 N Keene St, Suite 200, Columbia, MO 65201-8104 | 2007-07-20 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134688534 | Thomas Havey | Specialist/Technologist | 600 E Stadium Boulevard, Columbia, MO 65201 | 2019-03-15 |
| 1881176121 | Darrea L Green | Nurse Practitioner | 3700 Interstate 70 Dr Se, Columbia, MO 65201 | 2018-09-04 |
| 1073092383 | Andrea L. Lingenfelter | Registered Nurse | 1605 East Broadway, Ste. 100, Columbia, MO 65201 | 2018-08-08 |
| 1144724238 | Angela Marie Richmond | Internal Medicine | 1 Hospital Dr Rm Ma423, Columbia, MO 65201 | 2018-03-22 |
| 1770092892 | Palmer's Home Care, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 701 Hillsdale Road, Columbia, MO 65201 | 2017-09-20 |
| 1205358710 | Mitchell E Swee | Specialist/Technologist | 600 East Stadium Blvd, Columbia, MO 65201 | 2017-07-17 |
| 1659815470 | Colleen Jockin | Specialist | 100 Matc, Columbia, MO 65201 | 2016-12-13 |
| 1720535305 | Hannah Garrad | Dietitian, Registered | Columbia 3, 25 Conley Road, Columbia, MO 65201 | 2016-09-01 |
| 1043662570 | Restoration Chiropractic LLC | Chiropractor | 1413 Grindstone Plaza Drive, Columbia, MO 65201 | 2016-07-08 |
| 1306298930 | Taylor John Sirois | Chiropractor | 1413 Grindstone Plaza Dr., Columbia, MO 65201 | 2016-07-07 |
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| Taxonomy Code | 207RH0003X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Hematology & Oncology |
| An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912988536 | Mary Audrey Ackerman | Internal Medicine | 166 Stoneridge Dr, Columbia, SC 29210-8239 | 2005-11-10 |
| 1356322812 | Robert E Smith Jr. | Internal Medicine | 166 Stoneridge Drive, Columbia, SC 29210 | 2005-11-10 |
| 1952657462 | Jaffar Hilli | Internal Medicine | One Hospital Drive, Columbia, MO 65212-0001 | 2012-08-02 |
| 1851654818 | Andrew Mcmorris Iliff | Internal Medicine | 1705 E Broadway Ste 100, Columbia, MO 65201 | 2012-06-24 |
| 1902196165 | Varun Choudary Dhulipala | Internal Medicine | 1224 Trotwood Ave, Columbia, TN 38401-4802 | 2011-04-08 |
| 1891084513 | Andrew Scott Mener | Internal Medicine | 10710 Charter Dr, Columbia, MD 21044-3128 | 2011-04-04 |
| 1730495250 | Liana Makarian | Internal Medicine | 1705 E Broadway, Columbia, MO 65201-7166 | 2010-08-21 |
| 1821271032 | Maryland Oncology Hematology, P.a. | Internal Medicine | 10710 Charter Dr, Suite G020, Columbia, MD 21044-3128 | 2007-12-11 |
| 1922205681 | Amruth Palla | Internal Medicine | 1 Hospital Dr, Columbia, MO 65212-0001 | 2007-06-27 |
| 1124236286 | Yuanjue Louann Zhang | Internal Medicine | 11065 Little Patuxent Pkwy, Columbia, MD 21044-2998 | 2007-05-20 |
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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.