MARK K KEOHANE (NPI# 1710980750) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710980750 |
| Entity Type | Individual |
| Full Name | MARK K KEOHANE |
| Credential | M.D. |
| Practice Address |
9323 Phoenix Village Pkwy O Fallon MO 63366-4281 |
| Practice Telephone | 6365615030 |
| Practice Fax Number | 6365615033 |
| Mailing Telephone | 6365615030 |
| Mailing Fax Number | 6365615033 |
| Enumeration Date | 2005-05-23 |
| Last Update Date | 2012-03-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207X00000X | Orthopaedic Surgery | 34653 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CMR | 43177 | 01 | |
| HEALTHCARE USA | 4434V6097 | 01 | |
| BLUE CROSS BLUE SHIELD | 18883 | 01 | |
| AETNA | 4061116 | 01 | |
| UHC | 900094 | 01 | |
| CIGNA DMERC | 351240001 | 01 | |
| EXCLUSIVE CHOICE | 9043 | 01 | |
| HEALTHLINK | 122683 | 01 | |
| GHP/ADVANTRA | 2253V3458 | 01 | |
| CIGNA | SP10133 | 01 |
| Street Address |
9323 PHOENIX VILLAGE PKWY |
| City | O FALLON |
| State | MO |
| Zip Code | 63366-4281 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205839354 | Emil A Difilippo | Orthopaedic Surgery | 9323 Phoenix Village Pkwy, O Fallon, MO 63366-4281 | 2005-05-23 |
| 1073904769 | Signature Medical Group, Inc | Durable Medical Equipment & Medical Supplies | 9323 Phoenix Village Pkwy, O Fallon, MO 63368-4281 | 2015-02-17 |
| 1447454103 | Kevin James Quigley | Orthopaedic Surgery | 9323 Phoenix Village Pkwy, O Fallon, MO 63368-4281 | 2007-06-14 |
| 1437264595 | Jeffrey Steven Boberg | Podiatrist | 9323 Phoenix Village Pkwy, O Fallon, MO 63368-4281 | 2006-08-20 |
| 1174561211 | Matthew Paul Melander | Orthopaedic Surgery | 9323 Phoenix Village Pkwy, O Fallon, MO 63368-4281 | 2006-06-02 |
| 1275536120 | James E Schaberg | Orthopaedic Surgery | 9323 Phoenix Village Pkwy, O Fallon, MO 63366-4281 | 2005-05-24 |
| 1710980875 | Anthony J Berni | Orthopaedic Surgery | 9323 Phoenix Village Pkwy, O Fallon, MO 63366-4281 | 2005-05-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407314826 | Transformative Health 180 LLC | Physical Therapist | 821 West Terra Lane, O Fallon, MO 63366 | 2019-03-05 |
| 1740754126 | Donna Marie Person | Nurse Practitioner | 331 Magnolia Valley Dr., Ofallon, MO 63366 | 2019-01-18 |
| 1679069470 | Samantha Schulte | Clinical Pharmacology | 7 Poor Richard Ct, O Fallon, MO 63366 | 2018-07-03 |
| 1790218048 | Jill Buery | Marriage & Family Therapist | 801 S Woodlawn Ave, Ste 15, O'fallon, MO 63366 | 2017-04-04 |
| 1114466968 | Jessica Anne Morris | Counselor | 103 Lincoln Street, O'fallon, MO 63366 | 2017-02-13 |
| 1639528540 | Kyle James Neuschaefer | Dentist | 31 Ofallon Sq, O Fallon, MO 63366 | 2016-06-10 |
| 1295116143 | Katherine Seiler Harkess | Obstetrics & Gynecology | 300 Winding Woods Drive Suite 200, O'fallon, MO 63366 | 2015-06-16 |
| 1528453354 | Amanda Flamm | Nurse Practitioner | 1101 Hightway K, Ofallon, MO 63366 | 2015-03-30 |
| 1144639972 | Sara Birkemeier | Physical Therapist | 1541 Norwood Hills Dr, Ofallon, MO 63366 | 2014-08-06 |
| 1710390893 | Catherine Rose Most | Speech-Language Pathologist | 555 E. Terra Lane, Fort Zumwalt School District, O'fallon, MO 63366 | 2014-06-06 |
| Find all providers in zip 63366 | ||||
| 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 |
|---|---|---|---|---|
| 1205839354 | Emil A Difilippo | Orthopaedic Surgery | 9323 Phoenix Village Pkwy, O Fallon, MO 63366-4281 | 2005-05-23 |
| 1649618554 | Oa Associates, LLC | Orthopaedic Surgery | 310 N Seven Hills Rd, O Fallon, IL 62269-4111 | 2013-06-13 |
| 1023379369 | Travis J Junge | Orthopaedic Surgery | 3 Saint Elizabeth Blvd Ste 5000, O Fallon, IL 62269-1282 | 2012-06-04 |
| 1003137662 | Oa Associates, LLC | Orthopaedic Surgery | 800 E Highway 50, O Fallon, IL 62269-2844 | 2010-06-17 |
| 1316130503 | Physician Groups Lc | Orthopaedic Surgery | 2630 Highway K, O Fallon, MO 63368-6624 | 2007-08-22 |
| 1447454103 | Kevin James Quigley | Orthopaedic Surgery | 9323 Phoenix Village Pkwy, O Fallon, MO 63368-4281 | 2007-06-14 |
| 1932152980 | Donald Alan Weimer | Orthopaedic Surgery | 1512 N Green Mount Rd, Suite 300, O Fallon, IL 62269-1953 | 2006-05-19 |
| 1275536120 | James E Schaberg | Orthopaedic Surgery | 9323 Phoenix Village Pkwy, O Fallon, MO 63366-4281 | 2005-05-24 |
| 1710980875 | Anthony J Berni | Orthopaedic Surgery | 9323 Phoenix Village Pkwy, O Fallon, MO 63366-4281 | 2005-05-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245725605 | Brian Geraghty | Orthopaedic Surgery | 201 Nw R D Mize Road, Blue Springs, MO 64014 | 2018-06-28 |
| 1588164347 | Orthopedic Associates of Jc, LLC | Orthopaedic Surgery | 19201 E Valley View Pkwy Ste C, Independence, MO 64055-6913 | 2018-02-19 |
| 1760903850 | Adam J Martin | Orthopaedic Surgery | 621 S New Ballas Rd Ste 3005b, Saint Louis, MO 63141-8266 | 2017-06-29 |
| 1922528249 | Chikezie Okeagu | Orthopaedic Surgery | 621 South New Ballas, St. Louis, MO 63141 | 2017-06-27 |
| 1669901997 | Patrick David Rowan | Orthopaedic Surgery | 1100 Virginia Avenue Dc 953 00, Columbia, MO 65212-0001 | 2017-06-09 |
| 1003268087 | Advanced Orthopedics and Sports Medicine | Orthopaedic Surgery | 2861 Ne Independence Ave Ste 201, Lees Summit, MO 64064-2379 | 2016-07-01 |
| 1801254164 | St. Anthony's Physician Organization | Orthopaedic Surgery | 12700 Southfork Rd Ste 100, Saint Louis, MO 63128-3201 | 2016-02-02 |
| 1699156760 | Paul Hutchinson | Orthopaedic Surgery | 1100 Virginia Ave Rm 4056, Columbia, MO 65212-0001 | 2015-06-15 |
| 1447660451 | Tyson Travis | Orthopaedic Surgery | 2820 E Rock Haven Rd Ste 120, Harrisonville, MO 64701-4413 | 2014-04-29 |
| 1285051482 | Michael Joseph Reiter | Orthopaedic Surgery | 3009 N Ballas Rd Ste 269c, Saint Louis, MO 63131-2339 | 2014-03-25 |
| Find all providers with the same taxonomy | ||||
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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.