BRIAN MADDOX (NPI# 1780177188) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780177188 |
| Entity Type | Individual |
| Full Name | BRIAN MADDOX |
| Credential | AA |
| Practice Address |
3801 S National Ave Springfield MO 65807-5210 |
| Mailing Address |
1000 E Primrose St Ste 520 Springfield MO 65807-5180 |
| Practice Telephone | 4172694550 |
| Enumeration Date | 2018-06-11 |
| Last Update Date | 2018-06-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 367H00000X | Anesthesiologist Assistant | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | MO LICENSE | 2018019394 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588002554 | Brian Curtis Maddox | Family Medicine | 319 8th St, Suite1, Henderson, KY 42420-2963 | 2013-06-11 |
| Street Address |
3801 S NATIONAL AVE |
| City | SPRINGFIELD |
| State | MO |
| Zip Code | 65807-5210 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144224569 | John W Clouse | Specialist | 3801 S National Ave, Springfield, MO 65807-5210 | 2005-06-13 |
| 1518568377 | Anna Marie Laffoon | Dietitian, Registered | 3801 S National Ave, Springfield, MO 65807-5210 | 2020-11-06 |
| 1164020822 | Amber Fullington | Nurse Practitioner | 3801 S National Ave, Springfield, MO 65807-5210 | 2020-10-15 |
| 1013522150 | Jessica N Rice | Nurse Practitioner | 3801 S National Ave, Springfield, MO 65807-5210 | 2020-09-15 |
| 1649880618 | Amber Littleton | Midwife | 3801 S National Ave, Springfield, MO 65807-5210 | 2020-08-05 |
| 1689283988 | Kelley Lizabeth Miller | Nurse Practitioner | 3801 S National Ave, Springfield, MO 65807-5210 | 2020-07-23 |
| 1801404140 | Alyssa Nicole Reeves | Nurse Practitioner | 3801 S National Ave, Springfield, MO 65807-5210 | 2020-07-22 |
| 1255949624 | Lori Marie Burkard | Speech-Language Pathologist | 3801 S National Ave, Springfield, MO 65807-5210 | 2020-07-21 |
| 1316555980 | Jessica Graff | Nurse Practitioner | 3801 S National Ave, Springfield, MO 65807-5210 | 2020-07-20 |
| 1033736137 | Asher Herbet | Anesthesiologist Assistant | 3801 S National Ave, Springfield, MO 65807-5210 | 2020-07-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396390241 | Karley Kassandra Murphy | Counselor | 3734 South Ave #c, Springfield, MO 65807 | 2019-08-07 |
| 1396203626 | Auvia L Logan | Dietitian, Registered | 3322 S. Campbell Ave. Suite Cc, Springfield, MO 65807 | 2019-03-05 |
| 1598250961 | Kathryn Barber | Nurse Practitioner | 3800 S National Ave Ste 700, Springfield, MO 65807 | 2018-06-27 |
| 1447764899 | Missouri Midwifery Service | Clinic/Center | 3840 South Avenue, Springfield, MO 65807 | 2017-11-21 |
| 1124530290 | Senior Living Management Group, LLC | Skilled Nursing Facility | 3705 S Jefferson Ave, Springfield, MO 65807 | 2017-10-30 |
| 1740663335 | Sarah E Kirk | Physical Therapist | 3545 S. National Ave, Springfield, MO 65807 | 2015-07-01 |
| 1750713335 | Amanda Ward | Nurse Practitioner | 2150 W Republic Rd Ste 112, Springfield, MO 65807 | 2013-08-06 |
| 1932531126 | Eugenia R Cortez | Counselor | 2124 Chesterfield Blvd., Springfield, MO 65807 | 2013-07-30 |
| 1962742866 | Missouri Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 3045 W Republic St, Springfield, MO 65807 | 2013-03-01 |
| 1033462387 | Miguel Angel Medina | Physician Assistant | 1900 South Sunshine Ave., Springfield, MO 65807 | 2012-10-24 |
| Find all providers in zip 65807 | ||||
| Taxonomy Code | 367H00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Anesthesiologist Assistant |
| An individual certified by the state to perform anesthesia services under the direct supervision of an anesthesiologist. Anesthesiologist Assistants are required to have a bachelor's degree with a premed curriculum prior to entering a two-year anesthesiology assistant program, which is focused upon the delivery and maintenance of anesthesia care as well as advanced patient monitoring techniques. An Anesthesiologist Assistant must work as a member of the anesthesia care team under the direction of a qualified Anesthesiologist. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538418793 | Brent R Fairbanks | Anesthesiologist Assistant | 1235 E Cherokee, Springfield, MO 65804-2203 | 2012-09-04 |
| 1801408190 | Anthony R Hogan | Anesthesiologist Assistant | 100 W Main St, Springfield, OH 45502-1312 | 2020-08-19 |
| 1033736137 | Asher Herbet | Anesthesiologist Assistant | 3801 S National Ave, Springfield, MO 65807-5210 | 2020-07-06 |
| 1710501770 | Brittany Fox | Anesthesiologist Assistant | 3801 S National Ave, Springfield, MO 65807-5210 | 2020-06-04 |
| 1316592967 | Joshua Rogers | Anesthesiologist Assistant | 3801 S National Ave, Springfield, MO 65807-5210 | 2019-08-09 |
| 1750941431 | Madison Blair Howard | Anesthesiologist Assistant | 3801 S National Ave, Springfield, MO 65807-5210 | 2019-06-16 |
| 1356901060 | Sean Michael Apple | Anesthesiologist Assistant | 3801 S National Ave, Springfield, MO 65807-5210 | 2019-06-14 |
| 1891353892 | Jason Bradley Laughlin | Anesthesiologist Assistant | 1000 E Primrose St Ste 520, Springfield, MO 65807-7002 | 2019-06-04 |
| 1053979138 | Kayla Conner Hickey | Anesthesiologist Assistant | 1000 E Primrose St Ste 520, Springfield, MO 65807-5180 | 2019-06-03 |
| 1710462635 | Catherine Hogan | Anesthesiologist Assistant | 100 W Main St, Springfield, OH 45502-1312 | 2018-09-26 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 65807 |
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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.