ROBERT NIEBERGALL (NPI# 1912975012) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912975012 |
| Entity Type | Individual |
| Full Name | ROBERT NIEBERGALL |
| Credential | MD |
| Practice Address |
800 W Boise Cir Ste 160 Broken Arrow OK 74012-4932 |
| Practice Telephone | 9189949160 |
| Practice Fax Number | 9184036306 |
| Mailing Telephone | 9189949160 |
| Mailing Fax Number | 9184036306 |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2018-09-20 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 13607 | OK | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | 100014070A | 05 | |
| OK | MEDICARE GROUP PIN | 800522535 | 01 |
| Street Address |
800 W BOISE CIR STE 160 |
| City | BROKEN ARROW |
| State | OK |
| Zip Code | 74012-4932 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427033620 | Anthony Barbettini | Physician Assistant | 800 W Boise Cir Ste 160, Broken Arrow, OK 74012 | 2005-12-09 |
| 1396253043 | Corinne Onigbinde | Physician Assistant | 800 W Boise Cir Ste 160, Broken Arrow, OK 74012-4932 | 2018-01-16 |
| 1356799142 | Jennifer Janette Vanderford | Nurse Practitioner | 800 W Boise Cir Ste 160, Broken Arrow, OK 74012-4932 | 2016-06-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154949139 | Bonnie Jordan James | Pharmacist | 915 E Kenosha St, Broken Arrow, OK 74012 | 2020-07-07 |
| 1548814874 | Flawless Smile Dentistry of Ba Pllc | Dentist | 2319 N. 9th Street, Broken Arrow, OK 74012 | 2019-07-25 |
| 1780236653 | Carefirst Pharmacy Inc. | Pharmacy | 2530 N. Elm Pl., Broken Arrow, OK 74012 | 2019-07-11 |
| 1043871213 | Stacy Lynn Mitchell | Counselor | 2035 W. Houson St., Suite A, Broken Arrow, OK 74012 | 2019-06-27 |
| 1497319297 | Sara Hart | Internal Medicine | 420 W. Stone Wood Drive, Broken Arrow, OK 74012 | 2019-04-26 |
| 1699262386 | Fulps Family Eye Care, LLC | Optometrist | 3300 S Aspen Ave Ste D, Broken Arrow, OK 74012 | 2018-04-18 |
| 1598284358 | Stephanie Sue Mcquarters | Clinical Medical Laboratory | 1840 South Lion Avenue, Broken Arrow, OK 74012 | 2017-09-13 |
| 1477072460 | Kama Rae Gettings | Nurse Practitioner | 4623 W. Kenosha St, Broken Arrow, OK 74012 | 2017-09-12 |
| 1689196727 | Kristen Sherie' Snyder | Case Manager/Care Coordinator | 1324 North Umbrella Avenue, Broken Arrow, OK 74012 | 2017-07-11 |
| 1699216754 | Hillside Wellness Plllp | Chiropractor | 2311 N 9th St, Suite 101, Broken Arrow, OK 74012 | 2017-03-09 |
| Find all providers in zip 74012 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073133880 | Dr Brandon Bailey Do Pllc | Internal Medicine | 3621 S Elder Blvd, Broken Arrow, OK 74011-1755 | 2020-04-22 |
| 1497319297 | Sara Hart | Internal Medicine | 420 W. Stone Wood Drive, Broken Arrow, OK 74012 | 2019-04-26 |
| 1700170222 | Mobile Physician's Office LLC | Internal Medicine | 3941 N Pine Ave, Broken Arrow, OK 74012-0459 | 2011-06-01 |
| 1265643852 | Anita Dhirubhai Patel | Internal Medicine | 901 W Vandalia St, Broken Arrow, OK 74012-6601 | 2007-05-24 |
| 1891819405 | Brian Eugene Blake | Internal Medicine | 7916 E Commercial St, Broken Arrow, OK 74014-2683 | 2007-03-19 |
| 1578524963 | William Obrien | Internal Medicine | 1129 S Aspen Ave, Broken Arrow, OK 74012-4859 | 2006-03-28 |
| 1245209113 | Laura Bilbruck | Internal Medicine | 800 W Boise Cir, Suite 160, Broken Arrow, OK 74012-4906 | 2006-03-14 |
| 1508865361 | Riley Mark Hill | Internal Medicine | 2950 S Elm Pl, Suite 256, Broken Arrow, OK 74012-7877 | 2005-07-14 |
| 1467686717 | Rim Tabbaa | Internal Medicine | 2950 S Elm Pl, Suite 260, Broken Arrow, OK 74012-7877 | 2009-05-14 |
| 1023296746 | Felicia Renee' Lee | Internal Medicine | 2950 S Elm Pl, Suite 260, Broken Arrow, OK 74012-7877 | 2008-02-05 |
| Find all providers in BROKEN ARROW | ||||
| City | BROKEN ARROW |
| Zip Code | 74012 |
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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.