MADISON MEDICAL CENTER (NPI# 1669514436) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669514436 |
| Entity Type | Organization |
| Organization Name | MADISON MEDICAL CENTER |
| Practice Address |
611 W Main St Fredericktown MO 63645-1111 |
| Mailing Address |
611 W Main St Po Box 431 Fredericktown MO 63645-1111 |
| Practice Telephone | 5737833341 |
| Practice Fax Number | 5737831096 |
| Mailing Telephone | 5737833341 |
| Mailing Fax Number | 5737831096 |
| Enumeration Date | 2007-02-12 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | RODNEY D GROSS (ADMINISTRATOR) |
| Authorized Official Telephone | 5737833341 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033115548 | Madison Medical Center | Clinic/Center | 13409 E 14 Mile Rd, Sterling Hts, MI 48312-6304 | 2005-06-21 |
| 1801948880 | Madison Medical Center | Pharmacy | 611 W Main St, Fredericktown, MO 63645-1111 | 2007-01-18 |
| 1245305408 | Madison Medical Center | Durable Medical Equipment & Medical Supplies | 611 W Main St, Fredericktown, MO 63645-1111 | 2006-11-22 |
| Street Address |
611 W MAIN ST |
| City | FREDERICKTOWN |
| State | MO |
| Zip Code | 63645-1111 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548235419 | Ashvin D. Patel | Emergency Medicine | 611 W Main St, Fredericktown, MO 63645-1111 | 2006-02-22 |
| 1306402680 | Alanna Guess | Nurse Practitioner | 611 W Main St, Fredericktown, MO 63645-1111 | 2019-05-13 |
| 1225487143 | Heather Cheaney | Clinical Nurse Specialist | 611 W Main St, Fredericktown, MO 63645-1111 | 2016-06-10 |
| 1225355027 | Craig J. Millham | Mechanotherapist | 611 W Main St, Fredericktown, MO 63645-1111 | 2010-05-03 |
| 1154648954 | Michele Rubel | Mechanotherapist | 611 W Main St, Fredericktown, MO 63645-1111 | 2010-05-03 |
| 1760630032 | Madison County Ambulance District | Ambulance | 611 W Main St, Fredericktown, MO 63645-1111 | 2008-08-28 |
| 1558545871 | Corinna D Defrancesco | Nurse Practitioner | 611 W Main St, Fredericktown, MO 63645-1111 | 2007-12-21 |
| 1780802512 | Susan Lee Krydynski | Occupational Therapist | 611 W Main St, Fredericktown, MO 63645-1111 | 2007-04-24 |
| 1801948880 | Madison Medical Center | Pharmacy | 611 W Main St, Fredericktown, MO 63645-1111 | 2007-01-18 |
| 1104973858 | Nancy D Lodge | Pediatrics | 611 W Main St, Fredericktown, MO 63645-1111 | 2007-01-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093193880 | Emily Engers | Counselor | 206 W Marvin Ave, Fredericktown, MO 63645 | 2015-05-12 |
| 1871823955 | Covenant Care Services, LLC | Custodial Care Facility | 1610 W. Hwy 72, Fredericktown, MO 63645 | 2010-01-12 |
| 1518110279 | East Missouri Action Agency, Inc. | Clinic/Center | 806 West College Rd, Fredericktown, MO 63645 | 2008-10-28 |
| 1679737324 | Linda Carole Cravens | Dentist | 731 W Main St, Guy A Walker Dds, Fredericktown, MO 63645 | 2008-07-11 |
| 1629286976 | Community Health Care Associates, Inc | Social Worker | 735 West Main, Fredericktown, MO 63645 | 2007-05-18 |
| 1467539031 | Madison Medical Center Stockhoff Memorial Nursing Home | Clinic/Center | 611 West Main Street, Fredericktown, MO 63645 | 2006-11-01 |
| 1487749537 | Covenant Care Services, LLC | Registered Nurse | 120 S. Mine Lamotte, Fredericktown, MO 63645 | 2006-10-04 |
| 1215577945 | Modern Mental Health | Community/Behavioral Health | 151 South Main Street, Suite B, Fredericktown, MO 63645 | 2020-01-10 |
| 1235392309 | Humberto Jose Olivero Lara | Family Medicine | 611 West Main Street, Fredericktown, MO 63645 | 2008-07-08 |
| 1003983859 | Madison Memorial Hospital Stockhoff Memorial Nursing Home | Pharmacy | 611 West Main Street, Fredericktown, MO 63645 | 2006-11-29 |
| Find all providers in zip 63645 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548235419 | Ashvin D. Patel | Emergency Medicine | 611 W Main St, Fredericktown, MO 63645-1111 | 2006-02-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053972349 | Alanna Diamond | Emergency Medicine | One Hospital Drive Emergency Medicine M652 Dc029.10, Columbia, MO 65212-0001 | 2019-06-26 |
| 1013573146 | Michael Habhab | Emergency Medicine | 1 Hospital Dr Emergency Medicine M562 Dc029.10, Columbia, MO 65212-0001 | 2019-05-14 |
| 1043730716 | Ian James Becker | Emergency Medicine | 1 Hospital Dr # Dc029.10, Columbia, MO 65212-1000 | 2017-06-23 |
| 1649628454 | Sphere Medical Group | Emergency Medicine | 916 Olive St Fl 4, Saint Louis, MO 63101-1459 | 2016-06-02 |
| 1487002523 | Christopher Adam Waranch | Emergency Medicine | University of Missouri Columbia, Department of Emergency Medicine, Columbia, MO 65212-0001 | 2016-05-31 |
| 1306220488 | Andrea Marie-gioia Spangler | Emergency Medicine | 1235 E Cherokee St Dept Of, Springfield, MO 65804-2203 | 2015-07-17 |
| 1205219045 | Maria Christina Creel-bulos | Emergency Medicine | 660 South Euclid Avenue Cb 8072, St Louis, MO 63110 | 2015-06-29 |
| 1669853230 | Megan Litzau | Emergency Medicine | 615 S New Ballas Road, St Louis, MO 63141 | 2015-06-09 |
| 1366829426 | Bigeye Emergency Physicians LLC | Emergency Medicine | 10 South Hospital Deive, Fulton, MO 65251 | 2015-04-28 |
| 1972999225 | Timothy O Olatunde | Emergency Medicine | 4410 Wornall Road, Kansas City, MO 64111 | 2015-04-14 |
| Find all providers with the same taxonomy | ||||
| City | FREDERICKTOWN |
| Zip Code | 63645 |
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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.