DR. JUAN CARLOS SALAZAR (NPI# 1922041995) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922041995 |
| Entity Type | Individual |
| Full Name | DR. JUAN CARLOS SALAZAR |
| Credential | M.D. |
| Practice Address |
1140 Herschel Bess Blvd Poplar Bluff MO 63901-3075 |
| Mailing Address |
5716 Lake Shore Dr Poplar Bluff MO 63901-9648 |
| Practice Telephone | 5736861200 |
| Practice Fax Number | 5736861029 |
| Mailing Telephone | 5736862127 |
| Mailing Fax Number | 5737784156 |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2015-11-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
2000174358 | MO | Allopathic & Osteopathic Physicians |
| Y | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
2000174358 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| HEALTHLINK PPO | 461695 | 01 | |
| UNITED BEHAVIORAL HEALTH | 431116734 | 01 | |
| HEALTHLINK HMO | 461695 | 01 | |
| MO | 205345804 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639168008 | Juan Carlos Salazar | Dentist | 6799 Great Oaks Rd, Suite 201, Memphis, TN 38138-2508 | 2005-10-18 |
| 1003804741 | Juan Jose Salazar | Internal Medicine | 801 E Nolana, Ste #2, Mcallen, TX 78504 | 2005-10-06 |
| 1497234579 | Juan Carlos Salazar Jr. | Pharmacist | 1609 N Texas Ave, Bryan, TX 77803-1828 | 2018-08-09 |
| 1457849754 | Juan Salazar | Student in an Organized Health Care Education/Training Program | 4422 3rd Ave Bldg 3, Bronx, NY 10457-2545 | 2018-04-23 |
| 1730136748 | Juan A Salazar | Specialist | 6705 Red Rd, Suite 504, Coral Gables, FL 33143-3644 | 2006-05-27 |
| 1649246190 | Juan Carlos Salazar | Pediatrics | 282 Washington St, Hartford, CT 06106-3322 | 2006-02-24 |
| Street Address |
1140 HERSCHEL BESS BLVD |
| City | POPLAR BLUFF |
| State | MO |
| Zip Code | 63901-3075 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386814515 | Kimberly Lowe | Counselor | 1140 Herschel Bess Blvd, Poplar Bluff, MO 63901-3075 | 2008-03-04 |
| 1124214861 | Virginia Garcia | Case Manager/Care Coordinator | 1140 Herschel Bess Blvd, Poplar Bluff, MO 63901-3075 | 2007-09-17 |
| 1699961326 | Ericka Lee Tomlinson | Counselor | 1140 Herschel Bess Blvd, Poplar Bluff, MO 63901-3075 | 2007-09-17 |
| 1033305784 | Jeffrey E Killian | Counselor | 1140 Herschel Bess Blvd, Poplar Bluff, MO 63901-3075 | 2007-09-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568076701 | Alternative Sleep Solution | Dentist | 2700 Kanell Blvd., Poplar Bluff, MO 63901 | 2020-09-04 |
| 1285271239 | Front Door Wellness LLC | Physical Therapist | Front Door Wellness LLC, 5835 Quail Meadows Drive, Poplar Bluff, MO 63901 | 2019-12-09 |
| 1104470368 | Andrew Akindutire | Dentist | 3101 Oak Groove Rd., Suite 6, Poplar Bluff, MO 63901 | 2019-07-26 |
| 1780195966 | Midwest Equipment Srv Systems LLC | Technician, Pathology | 2400 Lucy Lee Parkway, Suite C, Poplar Bluff, MO 63901 | 2017-10-16 |
| 1801259387 | Richard Justin Huber | Technician, Other | 3005 Warrior Ln, Poplar Bluff, MO 63901 | 2016-04-01 |
| 1699136275 | Donja Kirkland | Recreation Therapist | 1910a Greenwood Dr., Suite D, Poplar Bluff, MO 63901 | 2016-03-10 |
| 1760866867 | Bio-medical Applications of Missouri, Inc. | Clinic/Center | 3050 Tucker Road, Poplar Bluff, MO 63901 | 2015-07-17 |
| 1407246390 | Lisa Marie Payne | Physical Therapist | 4358c Highway Pp, Poplar Bluff, MO 63901 | 2015-01-29 |
| 1700202488 | Missouri Dental Professionals, Richard Straus, Dmd, PC | Dentist | 1602 W. Harper Street, Poplar Bluff, MO 63901 | 2014-03-05 |
| 1932521648 | Essential Family Healthcare, LLC | Clinic/Center | 1369 North Westwood Blvd., Poplar Bluff, MO 63901 | 2014-01-15 |
| Find all providers in zip 63901 | ||||
| Taxonomy Code | 2084P0804X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Child & Adolescent Psychiatry |
| Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477194645 | Lotus Medical Associates LLC | Psychiatry & Neurology | 5100 Oak St Apt 433, Kansas City, MO 64112-2969 | 2019-09-30 |
| 1174008023 | East Central Missouri Behavioral Health Services, Inc. | Psychiatry & Neurology | 581 Commons Drive, Fulton, MO 65251 | 2018-09-26 |
| 1730622929 | Judith Hood Mckelvey | Psychiatry & Neurology | 9861 Copper Hill Rd, Saint Louis, MO 63124-1063 | 2016-11-21 |
| 1548664964 | Melody Ann Boling | Psychiatry & Neurology | 1 Hospital Dr # Dc067.00, Department of Psychiatry, Columbia, MO 65212-1000 | 2014-10-14 |
| 1629332259 | Oksana Baram | Psychiatry & Neurology | 10420 Old Olive Street Rd Ste 204, Saint Louis, MO 63141-5938 | 2012-06-28 |
| 1912293861 | Barbara Buchanan | Psychiatry & Neurology | 16760 S Village Dr, Village of Loch Lloyd, MO 64012-4166 | 2011-06-20 |
| 1710187539 | Danielle Mcgovern Bradshaw | Psychiatry & Neurology | 1101 E Hw 54, Womens Eastern Reception Diagnostic and Correctional Ce, Vandalia, MO 63382 | 2007-07-19 |
| 1689881567 | Pearl Fisher Serota | Psychiatry & Neurology | 621 S New Ballas Rd Ste 693a, Saint Louis, MO 63141-8263 | 2007-05-17 |
| 1154536100 | Rekha Ramanuja | Psychiatry & Neurology | 1220 N Lindbergh Blvd, Saint Louis, MO 63132-1704 | 2007-05-13 |
| 1649325390 | Clifton A Smith | Psychiatry & Neurology | 5931 S Highway 94, Weldon Spring, MO 63304-5611 | 2007-01-24 |
| Find all providers with the same taxonomy | ||||
| City | POPLAR BLUFF |
| Zip Code | 63901 |
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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.