CARLA PRINCE BOLIVAR (NPI# 1922233873) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922233873 |
| Entity Type | Individual |
| Full Name | CARLA PRINCE BOLIVAR |
| Other Name | CARLA PRINCE |
| Credential | M.D. |
| Practice Address |
515 Maple Valley Dr Farmington MO 63640-1919 |
| Mailing Address |
Po Box 843225 Kansas City MO 64184-3225 |
| Practice Telephone | 5737607920 |
| Practice Fax Number | 5737569597 |
| Mailing Telephone | 8132628160 |
| Mailing Fax Number | 8138919066 |
| Enumeration Date | 2009-05-21 |
| Last Update Date | 2016-01-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 2009022078 | MO | Allopathic & Osteopathic Physicians |
| Street Address |
515 MAPLE VALLEY DR |
| City | FARMINGTON |
| State | MO |
| Zip Code | 63640-1919 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730166505 | Rustico A Ramos | Family Medicine | 515 Maple Valley Dr, Farmington, MO 63640-1919 | 2005-12-22 |
| 1922569896 | Shannon Danielle Toole | Nurse Practitioner | 515 Maple Valley Dr, Farmington, MO 63640-1919 | 2019-03-25 |
| 1134300023 | Danielle Nicole Carron | Family Medicine | 515 Maple Valley Dr, Farmington, MO 63640-1919 | 2007-11-19 |
| 1255371944 | William D Johnson | Family Medicine | 515 Maple Valley Dr, Farmington, MO 63640-1919 | 2006-06-08 |
| 1164474557 | Karl D Killion | Family Medicine | 515 Maple Valley Dr, Farmington, MO 63640-1919 | 2006-05-16 |
| 1235180423 | Dennis E Sumski | Family Medicine | 515 Maple Valley Dr, Farmington, MO 63640-1919 | 2006-05-13 |
| 1942287735 | Brett Dickinson | Emergency Medicine | 515 Maple Valley Dr, Farmington, MO 63640-1919 | 2005-12-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316545254 | Brenda S Halton | Nurse Practitioner | 1010 West Columbia Street, Farmington, MO 63640 | 2020-10-13 |
| 1619519089 | Stacey Nicole Gillette | Counselor | 17885 Hart Pinkston Rd, Farmington, MO 63640 | 2019-10-17 |
| 1346890696 | Christopher Ryan Massey | Social Worker | 607 Pine St., Farmington, MO 63640 | 2019-09-18 |
| 1457909376 | Clarice Ogden | Social Worker | 203 South Washington Street, Farmington, MO 63640 | 2019-09-04 |
| 1861979718 | Clint Thebeau | In Home Supportive Care | 1276 W Liberty St, Farmington, MO 63640 | 2018-07-24 |
| 1023500600 | Lynn Machelle Knox | Counselor | 219 W Columbia St, Farmington, MO 63640 | 2018-05-31 |
| 1235620576 | Kim Bazzell | Registered Nurse | 1565 Ste. Genevieve Ave., Farmington, MO 63640 | 2018-05-22 |
| 1164919742 | Lincare Inc. | Durable Medical Equipment & Medical Supplies | 774 Market St, Farmington, MO 63640 | 2018-04-18 |
| 1184127813 | Michelle Lynette Corvallis | Chiropractor | 17 South Franklin St., Farmington, MO 63640 | 2018-03-08 |
| 1992206213 | Farmington Vision Care LLC | Optometrist | 110 E Harrison St, Farmington, MO 63640 | 2018-02-22 |
| Find all providers in zip 63640 | ||||
| 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 |
|---|---|---|---|---|
| 1841642659 | Mian Harris Iftikhar | Internal Medicine | Center On Aging 263 Farmington Avenue, Farmington, CT 06030-5215 | 2016-07-05 |
| 1275989410 | Pamela Georges Samaha | Internal Medicine | 2 West 263 Farmington Avenue, Internal Medicine Associates, Outpatient Pavilion, Farmington, CT 06032 | 2016-05-06 |
| 1366821878 | John J. Wisniewski | Internal Medicine | 36728 Brittany Hill Dr, Farmington, MI 48335-2906 | 2015-05-29 |
| 1972914901 | Ryan Alexander Darnall | Internal Medicine | Uconn Health Center School of Medicine, General Medicine Clinic-mc2811 263 Farmington Ave., Farmington, CT 06030-2811 | 2014-05-13 |
| 1598104564 | Cynthia Evans | Internal Medicine | Primary Care Internal Medicine, Uconn Health Center 263 Farmington Ave., Farmington, CT 06030-1234 | 2013-06-22 |
| 1790030195 | Bishan Chakravarty | Internal Medicine | 703 Maple Valley Drive, Farmington, MO 63640 | 2012-07-21 |
| 1790045086 | Yuriy Kulyak | Internal Medicine | 270 Farmington Ave Ste 352, Farmington, CT 06032-1996 | 2012-05-21 |
| 1740569763 | Genesis Physician Associates LLC | Internal Medicine | 4801 N Butler Avenue, Suite 8102, Farmington, NM 87401-0818 | 2011-08-08 |
| 1285927996 | David Rice, Md, LLC, P.a. | Internal Medicine | 107 Box Shop Hl, Farmington, ME 04938-5749 | 2011-05-27 |
| 1639499759 | Jaime Padavil Moskowitz | Internal Medicine | 406 Farmington Ave, Farmington, CT 06032-1964 | 2010-06-11 |
| Find all providers in FARMINGTON | ||||
| City | FARMINGTON |
| Zip Code | 63640 |
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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.