DR. DALE E. HAVERSTICK (NPI# 1902983075) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902983075 |
| Entity Type | Individual |
| Full Name | DR. DALE E. HAVERSTICK |
| Credential | MD |
| Practice Address |
Highway 19 South Eminence MO 65466 |
| Mailing Address |
Po Box 2580 Springfield MO 65801-2580 |
| Practice Telephone | 5732265401 |
| Practice Fax Number | 5732263011 |
| Mailing Telephone | 4178294620 |
| Mailing Fax Number | 4178294316 |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2008-07-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 109158 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 208585935 | 05 |
| Street Address |
HIGHWAY 19 SOUTH |
| City | EMINENCE |
| State | MO |
| Zip Code | 65466 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073951273 | Mercy St Francis Hospital | Clinic/Center | Highway 19 South, Eminence, MO 65466 | 2013-06-10 |
| 1396871745 | Mercy Clinic-springfield Communities | Family Medicine | Highway 19 South, Eminence, MO 65466 | 2007-02-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780167650 | Eminence R-1 School District | Local Education Agency (LEA) | 17829 South 6th Street, Eminence, MO 65466 | 2018-09-07 |
| 1154801611 | Regional Services | Nurse Practitioner | 505 S 6th St, Eminence, MO 65466 | 2018-08-15 |
| 1477728244 | Dale Family Medicine | Clinic/Center | 106 Highway West, Eminence, MO 65466 | 2008-04-23 |
| 1194837187 | Sherry K Foster | Licensed Practical Nurse | 209 Main St., Eminence, MO 65466 | 2006-08-31 |
| 1356343826 | Joseph Chester Francis Camire | Family Medicine | 17959 Main Street, Eminence, MO 65466 | 2005-08-12 |
| 1366749764 | Susan M Norris | Nurse Practitioner | 17959 Main Street, Eminence, MO 65466 | 2011-02-21 |
| 1790815405 | Shannon County Health Center | In Home Supportive Care | 18018 Grey Jones Drive, Eminence, MO 65466 | 2007-03-06 |
| 1528198157 | Shannon County Health Center | Public Health or Welfare | 18018 Grey Jones Drive, Eminence, MO 65466 | 2007-03-06 |
| 1104956820 | Shannon County Health Center | In Home Supportive Care | 18018 Grey Jones Drive, Eminence, MO 65466 | 2007-03-06 |
| 1972606895 | Big Springs Medical Association | Clinic/Center | 17959 Main Street, Eminence, MO 65466 | 2006-09-06 |
| Find all providers in zip 65466 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710976352 | Kenneth A. Gardner | Family Medicine | 150 Fairview Court, Eminence, KY 40019 | 2005-10-17 |
| 1356343826 | Joseph Chester Francis Camire | Family Medicine | 17959 Main Street, Eminence, MO 65466 | 2005-08-12 |
| 1396871745 | Mercy Clinic-springfield Communities | Family Medicine | Highway 19 South, Eminence, MO 65466 | 2007-02-27 |
| 1952390569 | David A Jones | Family Medicine | 150 Fairview Ct, Eminence, KY 40019-1158 | 2005-10-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811596877 | Stephanie R Nicholson | Family Medicine | 4500 S Park Ave, Sedalia, MO 65301-8525 | 2020-10-21 |
| 1053919514 | Kelli Lichte | Family Medicine | 601 S 13 Hwy, Lexington, MO 64067-1511 | 2020-10-15 |
| 1053927228 | Cox- Monett Hospital, Inc. | Family Medicine | 1000 E Hwy 60, Monett, MO 65708 | 2020-09-22 |
| 1104432806 | Jefferson Medical Group | Family Medicine | 807 E Broadway St, Brunswick, MO 65236-1468 | 2020-09-17 |
| 1124633995 | Continuum Family Care LLC | Family Medicine | 2336 S Main St, Maryville, MO 64468-3622 | 2020-09-09 |
| 1326652579 | Linda Diane Watson | Family Medicine | 338 Emerson Rd Apt 104, High Ridge, MO 63049-2530 | 2020-09-04 |
| 1447868005 | Brittany Mechelle Waterworth | Family Medicine | 3700 I 70 Dr Se Ste 106, Columbia, MO 65201-6587 | 2020-07-20 |
| 1013542828 | Johns Healthcare Services LLC | Family Medicine | 2001 Independence St Ste A, Cape Girardeau, MO 63703-5805 | 2020-03-12 |
| 1972133460 | Fnp4jc, LLC | Family Medicine | 215 North Street, Waynesville, MO 65583 | 2020-01-23 |
| 1568092732 | Scotland County Memorial Hospital | Family Medicine | 55682 State Highway 6, Edina, MO 63537-4267 | 2020-01-16 |
| 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.