DR. JACOB ANDREW SEDRICK (NPI# 1699935064) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699935064 |
| Entity Type | Individual |
| Full Name | DR. JACOB ANDREW SEDRICK |
| Credential | DO |
| Practice Address |
100 Mercy Way Joplin MO 64804-4524 |
| Practice Telephone | 4175564762 |
| Practice Fax Number | 4175566321 |
| Mailing Telephone | 4175564762 |
| Mailing Fax Number | 4175566321 |
| Enumeration Date | 2008-06-10 |
| Last Update Date | 2015-07-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
2015014437 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | 200590630A | 05 | |
| MO | 1699935064 | 05 |
| Street Address |
100 MERCY WAY |
| City | JOPLIN |
| State | MO |
| Zip Code | 64804-4524 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659378693 | Ajit S Nagra | Anesthesiology | 100 Mercy Way, Joplin, MO 64804-4524 | 2005-07-06 |
| 1538782537 | Ruby Nicole Tollison | Registered Nurse | 100 Mercy Way, Joplin, MO 64804-4524 | 2020-05-26 |
| 1801416508 | Kristina Marie Crosby | Registered Nurse | 100 Mercy Way, Joplin, MO 64804-4524 | 2020-04-22 |
| 1023637071 | Casey Lane Truitt | Registered Nurse | 100 Mercy Way, Joplin, MO 64804-4524 | 2020-04-09 |
| 1346878485 | Matthew Zachary Wohlfahrt | Registered Nurse | 100 Mercy Way, Joplin, MO 64804-4524 | 2020-04-01 |
| 1801436779 | Lindsay Marcy | Nurse Practitioner | 100 Mercy Way, Joplin, MO 64804-4524 | 2020-01-08 |
| 1548811219 | Kayley Myers | Dietitian, Registered | 100 Mercy Way, Joplin, MO 64804-4524 | 2019-09-24 |
| 1992367502 | Kendrick R Maus | Nurse Practitioner | 100 Mercy Way, Joplin, MO 64804-4524 | 2019-07-03 |
| 1669036075 | Morgan Gilkerson | Nurse Anesthetist, Certified Registered | 100 Mercy Way, Joplin, MO 64804-4524 | 2019-05-01 |
| 1831655745 | Sue Ann Denney | Registered Nurse | 100 Mercy Way, Joplin, MO 64804-4524 | 2019-02-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033718903 | Lisa Jo Moore | Nurse Practitioner | 2623 S Main Street, Nixa, MO 64804 | 2020-10-22 |
| 1346859600 | Centered and Connected LLC | Counselor | 2401 E 32nd St, Ste 10 #103, Joplin, MO 64804 | 2020-07-23 |
| 1649838780 | Nicole Lynn Egan | Social Worker | 3010 Mcclelland, Joplin, MO 64804 | 2019-06-04 |
| 1902361652 | Redings Mill Internal Care | Clinic/Center | 454 Redings Mill Rd, Joplin, MO 64804 | 2019-02-06 |
| 1447732508 | Urgent Care Travel, Inc | Clinic/Center | 5931 E 32nd Street, Joplin, MO 64804 | 2018-09-05 |
| 1912488891 | Karl G. Keczkemethy | Dietitian, Registered | 100 Mercy Way Ste 570, Joplin, MO 64804 | 2018-08-28 |
| 1790207546 | Jacksie Short | Dentist | 2819 E 29th St, Joplin, MO 64804 | 2017-07-13 |
| 1326574625 | Kristine Kwon Rowland | Nurse Practitioner | 100 Mercy Way Ste 320-330, Joplin, MO 64804 | 2017-05-05 |
| 1942735212 | West R Loveland | Counselor | 3230 S Wisconsin St Suite H, Joplin, MO 64804 | 2017-04-25 |
| 1174070205 | Tracy L Fry | Nurse Practitioner | 3333 Mcintosh Cir Ste 4, Joplin, MO 64804 | 2016-09-07 |
| Find all providers in zip 64804 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568092120 | Jeffrey Francis Schaffer | Radiology | 918 W Laurel Rd, Joplin, MO 64801-1052 | 2020-01-23 |
| 1477872265 | Randy Weiss | Radiology | 5237 Mcclelland Park Rd., Joplin, MO 64803-2785 | 2010-05-19 |
| 1316140650 | Lowell Kenneth Pottenger | Radiology | 4400 Eden Hall Ln, Joplin, MO 64803 | 2007-06-06 |
| 1386745503 | Southwest Radiology Ltd | Radiology | 1722 West 27th Street, Joplin, MO 64804 | 2006-09-26 |
| 1053604066 | Yara Touma | Radiology | 1102 W 32nd St, Joplin, MO 64804-3503 | 2011-05-24 |
| 1043525959 | Jane Seto | Radiology | 1102 W 32nd St, Joplin, MO 64804-3503 | 2010-08-16 |
| 1467637769 | Hublall Radiology, LLC | Radiology | 1905 W 32nd St, Joplin, MO 64804-1529 | 2008-01-04 |
| 1962518530 | Joshua Michael Ball | Radiology | 1102 W 32nd St, Joplin, MO 64804-3503 | 2006-08-23 |
| 1003822123 | John K Williams | Radiology | 1102 W 32nd St, Joplin, MO 64804-3503 | 2006-07-31 |
| 1821004946 | Paul S Jones | Radiology | 1102 W 32nd St, Joplin, MO 64804-3503 | 2006-07-31 |
| Find all providers in JOPLIN | ||||
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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.