GARY PAUL QUILLEN (NPI# 1861895013) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861895013 |
| Entity Type | Individual |
| Full Name | GARY PAUL QUILLEN |
| Credential | ANP |
| Practice Address |
1068 S Woods Mill Rd Ste 220 Town and Country MO 63017-8333 |
| Practice Telephone | 3143941379 |
| Practice Fax Number | 3143941377 |
| Mailing Telephone | 3143941379 |
| Mailing Fax Number | 3143941377 |
| Enumeration Date | 2014-10-02 |
| Last Update Date | 2019-09-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
AG1014022 | MO | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LG0600X |
Nurse Practitioner Specialization: Gerontology |
AG1014022 | MO | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 1861895013 | 05 |
| Street Address |
1068 S WOODS MILL RD STE 220 |
| City | TOWN AND COUNTRY |
| State | MO |
| Zip Code | 63017-8333 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487677308 | Eric Scott Baggstrom | Internal Medicine | 1068 S Woods Mill Rd Ste 220, Town and Country, MO 63017-8333 | 2006-07-25 |
| 1952409971 | Christopher T. Labonte Md LLC | Internal Medicine | 1068 S Woods Mill Rd Ste 220, Town and Country, MO 63017-8333 | 2006-09-21 |
| 1093813099 | Christopher T. Labonte | Internal Medicine | 1068 S Woods Mill Rd Ste 220, Town and Country, MO 63017-8333 | 2006-09-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114549193 | Kathryn E Bos | Student in an Organized Health Care Education/Training Program | 873 Apt N Foxsprings Dr, Chesterfield, MO 63017 | 2020-05-12 |
| 1700415171 | Charles H. Edwards | Physical Therapist | 224 South Woods Millrd., Suite 610 South, Chesterfield, MO 63017 | 2020-04-07 |
| 1003454562 | Stephanie Henningsen | Physical Therapy Assistant | 307 S Woods Rd, Chesterfield, MO 63017 | 2019-12-16 |
| 1831746296 | Star Lynn Sutton | Occupational Therapy Assistant | 15207 Olive Boulevard, Chesterfield, MO 63017 | 2019-08-21 |
| 1639738438 | Van Amburg & Busiek Md's, LLC | Pharmacy | 232 S Woodsmill Road, Suite 330 East, Chesterfield, MO 63017 | 2019-06-06 |
| 1306306865 | Margaret Mary Wynn | Nurse Practitioner | 15740 South Outer Road, Chesterfield, MO 63017 | 2019-03-21 |
| 1205393089 | Kimberly Danielle | Nurse Practitioner | 744 Forest Trace Dr, Chesterfield, MO 63017 | 2019-02-27 |
| 1457823965 | Allison Joy Mcgrail | Dietitian, Registered | 45740 S Outer Forty Rd, Chesterfield, MO 63017 | 2018-12-21 |
| 1316418080 | Julie Lefere | Social Worker | Mercy Virtual Care Center, 15740 S Outer 40 Rd, Chesterfield, MO 63017 | 2018-12-06 |
| 1336629641 | Catherine Dolphin Smith | Nurse Practitioner | 224 S Woods Mill Rd Ste 500, Chesterfield, MO 63017 | 2018-08-16 |
| Find all providers in zip 63017 | ||||
| Taxonomy Code | 363LG0600X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Gerontology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023632932 | Rebecca Theresa Medlock | Nurse Practitioner | 736 Marco Valley Ct, Fenton, MO 63026-5318 | 2020-06-05 |
| 1083233274 | Gina Hart | Nurse Practitioner | 12101 Woodcrest Executive Dr Ste 102, Saint Louis, MO 63141-5047 | 2020-04-08 |
| 1215569512 | Nicole M Wikoff | Nurse Practitioner | 12415 Hickory Grove Ln, Saint Louis, MO 63146-3907 | 2020-02-05 |
| 1124658257 | Amadu Barrie | Nurse Practitioner | 134 Midland Avenue, Maryland Heights, MO 63043 | 2020-01-16 |
| 1922569995 | Sarah Regan | Nurse Practitioner | 1031 Bellevue Ave Ste 100, Saint Louis, MO 63117-1855 | 2019-03-30 |
| 1437615044 | Ashley M Berneking | Nurse Practitioner | 4122 Keaton Crossing Blvd Ste 102, O Fallon, MO 63368-8219 | 2019-02-19 |
| 1174094072 | Michelle Kay Bank | Nurse Practitioner | 12409 Roth Hill Dr, Maryland Heights, MO 63043-2941 | 2018-12-17 |
| 1861968612 | Nasir Gebi | Nurse Practitioner | 603 E Minor Dr Apt 202, Kansas City, MO 64131-3688 | 2018-10-19 |
| 1457839573 | Robert Claude Kamtio Kamgoum | Nurse Practitioner | 406 W 34th St Ste 428, Kansas City, MO 64111-3113 | 2018-07-31 |
| 1639613813 | University of Missouri | Nurse Practitioner | 1100 Virginina Ave, Columbia, MO 65212-0001 | 2016-12-07 |
| Find all providers with the same taxonomy | ||||
| City | TOWN AND COUNTRY |
| Zip Code | 63017 |
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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.