RAFFAELE PENNELLA MD LLC (NPI# 1568992782) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568992782 |
| Entity Type | Organization |
| Organization Name | RAFFAELE PENNELLA MD LLC |
| Practice Address |
3808 S Greystone Ct Springfield MO 65804-6561 |
| Mailing Address |
3808 S. Greystone Ct Springfield MO 65804 |
| Practice Telephone | (417) 889-3332 |
| Practice Fax Number | 4178811410 |
| Mailing Telephone | 4178893332 |
| Mailing Fax Number | 4178811410 |
| Enumeration Date | 2017-06-20 |
| Last Update Date | 2017-06-20 |
| Authorized Official Name | DR. RAFFAELE PENNELLA (PHYSICIAN/OWNER) |
| Authorized Official Telephone | 4178893332 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207ND0900X |
Dermatology Specialization: Dermatopathology |
110288 | MO | Allopathic & Osteopathic Physicians |
| Street Address |
3808 S GREYSTONE CT |
| City | SPRINGFIELD |
| State | MO |
| Zip Code | 65804-6561 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801866231 | Jenifer Dawn Insley | Dermatology | 3808 S Greystone Ct, Springfield, MO 65804-6561 | 2006-01-26 |
| 1356955231 | Erin F Lewis | Nurse Practitioner | 3808 S Greystone Ct, Springfield, MO 65804-6561 | 2020-09-08 |
| 1538773437 | Lesley Hawley Md LLC | Dermatology | 3808 S Greystone Ct, Springfield, MO 65804-6561 | 2020-09-08 |
| 1649793076 | Jenifer Insley Md LLC | Dermatology | 3808 S Greystone Ct, Springfield, MO 65804-6561 | 2017-07-18 |
| 1013456045 | Erin H York | Physician Assistant | 3808 S Greystone Ct, Springfield, MO 65804-6561 | 2017-02-23 |
| 1356570576 | Amanda R Goddard | Physician Assistant | 3808 S Greystone Ct, Springfield, MO 65804-6561 | 2009-07-09 |
| 1558400788 | Raffaele Pennella | Dermatology | 3808 S Greystone Ct, Springfield, MO 65804 | 2007-02-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790393049 | Kathy Forson | Nurse Practitioner | 1235 E. Cherokee St., Springfield, MO 65804 | 2020-07-22 |
| 1306498779 | Anne B Summers, LLC | Social Worker | 1310 E. Kingsley St., Ste C, Springfield, MO 65804 | 2019-07-15 |
| 1790241800 | Margaret Mary Hart | Social Worker | 1845 S Rogers Ave, Springfield, MO 65804 | 2019-02-13 |
| 1598254666 | Casey Carr | Optometrist | 1229 E Seminole St Ste 110, Springfield, MO 65804 | 2018-05-04 |
| 1124520697 | Shelby D White | Behavioral Analyst | 1300 E. Bradford Parkway, Springfield, MO 65804 | 2018-03-01 |
| 1316448343 | Karl Lynham | Massage Therapist | 1200 E Woodhurst Dr R300, Springfield, MO 65804 | 2018-02-25 |
| 1699273763 | Leah Wilson | Counselor | 1322 E Woodgate, Springfield, MO 65804 | 2018-01-24 |
| 1295242626 | Matthew Crisp | Physical Therapist | 3252 E Independence St, Springfield, MO 65804 | 2018-01-08 |
| 1518491042 | Crystal Spangler | Dietitian, Registered | 1965 S Fremont Ave Ste 220, Springfield, MO 65804 | 2017-04-11 |
| 1588012033 | Jeffrey Williams | Pharmacist | 1235 E. Cherokee, Springfield, MO 65804 | 2016-05-25 |
| Find all providers in zip 65804 | ||||
| Taxonomy Code | 207ND0900X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| Specialization | Dermatopathology |
| A dermatopathologist has the expertise to diagnose and monitor diseases of the skin including infectious, immunologic, degenerative and neoplastic diseases. This entails the examination and interpretation of specially prepared tissue sections, cellular scrapings and smears of skin lesions by means of routine and special (electron and fluorescent) microscopes. |
| 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 Dermatology, 2007. http://www.abderm.org/; American Osteopathic Board of Dermatology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Dermatology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427501394 | Dimmick Laughlin Dermatology LLC | Dermatology | 1530 E Primrose St Ste D, Springfield, MO 65804-7910 | 2016-07-27 |
| 1376794644 | Robert N Deangelis Md Ltd | Dermatology | 8346 Traford Ln, Springfield, VA 22152-1600 | 2008-10-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053437392 | Sunflower Dermatology & Day Spa LLC | Dermatology | 1805 Nw Platte Rd., Suite 120, Riverside, MO 64150 | 2007-03-21 |
| 1528447125 | Kristin Colleen Smith | Dermatology | 1755 S Grand Blvd, Saint Louis, MO 63104-1540 | 2015-05-28 |
| 1033396577 | Saint Luke's Hospital Physician Billing Services, LLC | Dermatology | 4320 Wornall Rd, Suite 513, Kansas City, MO 64111-5941 | 2008-01-28 |
| 1750335337 | Saint Lukes Physician Group II LLC | Dermatology | 4401 Wornall Rd, Kansas City, MO 64111-3220 | 2006-05-19 |
| 1821061151 | St Louis University | Dermatology | 1755 S Grand Blvd, Saint Louis, MO 63104-1540 | 2006-02-08 |
| City | SPRINGFIELD |
| Zip Code | 65804 |
Please comment or provide details below to improve the information on RAFFAELE PENNELLA MD LLC.
| 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.