MIDWEST HEALTH GROUP, LLC (NPI# 1760754386) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760754386 |
| Entity Type | Organization |
| Organization Name | MIDWEST HEALTH GROUP, LLC |
| Practice Address |
508 W Pine St Farmington MO 63640-1426 |
| Mailing Address |
2980 N Beverly Glen Cir Suite 301 Los Angeles CA 90077-1726 |
| Practice Telephone | 5737471510 |
| Mailing Telephone | 3104749809 |
| Enumeration Date | 2012-01-27 |
| Last Update Date | 2012-01-27 |
| Authorized Official Name | DR. PAUL MONIZ (OWNER) |
| Authorized Official Telephone | 5737471510 |
| Authorized Official Credential | D.O. |
| Is Organization Subpart | Y |
| Parent Organization Name | MIDWEST HEALTH GROUP, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332900000X | Non-Pharmacy Dispensing Site | Suppliers |
| Street Address |
508 W PINE ST |
| City | FARMINGTON |
| State | MO |
| Zip Code | 63640-1426 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316053028 | Gina Heberlie | Nurse Practitioner | 508 W Pine St, Farmington, MO 63640-1426 | 2006-08-23 |
| 1568088045 | Tanner Lorenz | Dentist | 508 W Pine St, Farmington, MO 63640-1426 | 2020-06-22 |
| 1568860641 | Parkcrest Orthopedics LLC | Orthopaedic Surgery | 508 W Pine St, Farmington, MO 63640-1426 | 2014-12-05 |
| 1922446384 | Great Mines Health Center | Clinic/Center | 508 W Pine St, Farmington, MO 63640-1426 | 2013-06-07 |
| 1356629430 | Christine A Herrington | Nurse Practitioner | 508 W Pine St, Farmington, MO 63640-1426 | 2011-07-24 |
| 1841584737 | Charles Justus Elkington | Dentist | 508 W Pine St, Farmington, MO 63640-1426 | 2011-06-08 |
| 1992884183 | Diane Marie Radosevich | Nurse Practitioner | 508 W Pine St, Farmington, MO 63640-1426 | 2006-11-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316545254 | Brenda S Halton | Nurse Practitioner | 1010 West Columbia Street, Farmington, MO 63640 | 2020-10-13 |
| 1619519089 | Stacey Nicole Gillette | Counselor | 17885 Hart Pinkston Rd, Farmington, MO 63640 | 2019-10-17 |
| 1346890696 | Christopher Ryan Massey | Social Worker | 607 Pine St., Farmington, MO 63640 | 2019-09-18 |
| 1457909376 | Clarice Ogden | Social Worker | 203 South Washington Street, Farmington, MO 63640 | 2019-09-04 |
| 1861979718 | Clint Thebeau | In Home Supportive Care | 1276 W Liberty St, Farmington, MO 63640 | 2018-07-24 |
| 1023500600 | Lynn Machelle Knox | Counselor | 219 W Columbia St, Farmington, MO 63640 | 2018-05-31 |
| 1235620576 | Kim Bazzell | Registered Nurse | 1565 Ste. Genevieve Ave., Farmington, MO 63640 | 2018-05-22 |
| 1164919742 | Lincare Inc. | Durable Medical Equipment & Medical Supplies | 774 Market St, Farmington, MO 63640 | 2018-04-18 |
| 1184127813 | Michelle Lynette Corvallis | Chiropractor | 17 South Franklin St., Farmington, MO 63640 | 2018-03-08 |
| 1992206213 | Farmington Vision Care LLC | Optometrist | 110 E Harrison St, Farmington, MO 63640 | 2018-02-22 |
| Find all providers in zip 63640 | ||||
| Taxonomy Code | 332900000X |
| Grouping | Suppliers |
| Classification | Non-Pharmacy Dispensing Site |
| A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.) |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801456959 | Fairview Pharmacy Services LLC | Non-Pharmacy Dispensing Site | 19685 Pilot Knob Rd, Farmington, MN 55024-7238 | 2019-06-19 |
| 1700353398 | Pain & Spine Specialists of Connecticut, LLC | Non-Pharmacy Dispensing Site | 11 South Rd Ste 250, Farmington, CT 06032-2484 | 2018-11-01 |
| 1982057501 | Midwest Health Group Convenient Care, LLC | Non-Pharmacy Dispensing Site | 550 Maple Valley Dr, Farmington, MO 63640-1981 | 2016-07-19 |
| 1174753305 | Health & Nutrition, LLC | Non-Pharmacy Dispensing Site | 630 Shepard Ln Ste 102, Farmington, UT 84025-3934 | 2009-07-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558909150 | Dedicated Missouri Holding, LLC | Non-Pharmacy Dispensing Site | 3649 Page Blvd, Saint Louis, MO 63113-3807 | 2019-12-13 |
| 1568945103 | Ficom | Non-Pharmacy Dispensing Site | 1308 North Glenstone Avenue, Springfield, MO 65802 | 2018-09-10 |
| 1033629761 | Cerner Health Connections, Inc | Non-Pharmacy Dispensing Site | 6601 Winchester Ave Ste 240, Kansas City, MO 64133-4657 | 2017-10-09 |
| 1861948697 | Midwest Health Group Convenient Care, LLC | Non-Pharmacy Dispensing Site | 123 N Mine La Motte St, Fredericktown, MO 63645-1201 | 2016-08-31 |
| 1114291515 | Burns & Mcdonnell | Non-Pharmacy Dispensing Site | 9400 Ward Pkwy, Kansas City, MO 64114-3319 | 2012-03-02 |
| 1811131956 | U.S. Optical | Non-Pharmacy Dispensing Site | 2346 S Campbell Ave, Springfield, MO 65807-2972 | 2009-04-20 |
| 1467661157 | Vitalsurge LLC | Non-Pharmacy Dispensing Site | 702 W 42nd St, Joplin, MO 64804-4564 | 2007-05-21 |
| 1477767259 | Ion Pharmaceuticals | Non-Pharmacy Dispensing Site | 2190 1st Capitol Dr, Saint Charles, MO 63301-5804 | 2007-05-10 |
| 1184703852 | Orthopedic Associates | Non-Pharmacy Dispensing Site | 1050 Des Peres Rd, Ste 100, Saint Louis, MO 63131-2042 | 2006-11-03 |
| 1790317402 | Dedicated Missouri Holding, LLC | Non-Pharmacy Dispensing Site | 175 N Oaks Plz, Saint Louis, MO 63121-2925 | 2020-02-10 |
| Find all providers with the same taxonomy | ||||
| City | FARMINGTON |
| Zip Code | 63640 |
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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.