SAMUEL LEE NIEDERGERKE (NPI# 1932611779) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932611779 |
| Entity Type | Individual |
| Full Name | SAMUEL LEE NIEDERGERKE |
| Practice Address |
411 Central Methodist Sq Fayette MO 65248-1104 |
| Mailing Address |
2126 County Road 362 New Bloomfield MO 65063-1111 |
| Practice Telephone | 6602483391 |
| Enumeration Date | 2017-11-02 |
| Last Update Date | 2017-11-02 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
411 CENTRAL METHODIST SQ |
| City | FAYETTE |
| State | MO |
| Zip Code | 65248-1104 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952399776 | Rick Errett Sage | Specialist/Technologist | 411 Central Methodist Sq, Fayette, MO 65248-1104 | 2005-10-06 |
| 1346734423 | Kimberly Mikulan | Specialist/Technologist | 411 Central Methodist Sq, Fayette, MO 65248-1104 | 2018-06-21 |
| 1013429851 | Kelsey Nicole Stuenkel | Specialist/Technologist | 411 Central Methodist Sq, Fayette, MO 65248-1104 | 2017-11-02 |
| 1023520863 | Bray Dempsey | Specialist/Technologist | 411 Central Methodist Sq, Fayette, MO 65248-1104 | 2017-11-02 |
| 1841702685 | Jacob Ryan Kent | Specialist/Technologist | 411 Central Methodist Sq, Fayette, MO 65248-1104 | 2017-11-02 |
| 1295247039 | Trevor Michael Barbour | Specialist/Technologist | 411 Central Methodist Sq, Fayette, MO 65248-1104 | 2017-11-02 |
| 1114439957 | Zach G Hentges | Specialist/Technologist | 411 Central Methodist Sq, Fayette, MO 65248-1104 | 2017-11-02 |
| 1750893590 | Ashley Elizabeth Wills | Specialist/Technologist | 411 Central Methodist Sq, Fayette, MO 65248-1104 | 2017-11-02 |
| 1205348042 | Mackenzie Lee Cullifer | Specialist/Technologist | 411 Central Methodist Sq, Fayette, MO 65248-1104 | 2017-11-02 |
| 1922510767 | Zendy Montalvo | Specialist/Technologist | 411 Central Methodist Sq, Fayette, MO 65248-1104 | 2017-11-02 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871658799 | Health Care Consultants of Mid Missouri, Inc. | Assisted Living Facility | 420 County Road 112, Fayette, MO 65248 | 2006-12-22 |
| 1326075391 | Robert Neal Buffaloe | Family Medicine | 308 S Church St, Fayette, MO 65248 | 2006-06-27 |
| 1740376219 | Howard County Home Health and Hospice | Hospice Care, Community Based | 101 Furr St, Fayette, MO 65248-1069 | 2006-10-04 |
| 1861496531 | Howard County Home Health and Hospice | Home Health | 101 Furr Street, Fayette, MO 65248-1069 | 2005-06-09 |
| 1013342955 | Howard County Home Health and Hospice | In Home Supportive Care | 101 Furr St, Fayette, MO 65248-1069 | 2013-09-11 |
| 1346242484 | Howard County Commission | Public Health or Welfare | 600 W Morrison St, Ste 7, Fayette, MO 65248-1075 | 2005-06-01 |
| 1700125382 | Jessica Michelle Beasley | Counselor | 600 W Morrison St, Ste 18, Fayette, MO 65248-1075 | 2013-02-02 |
| 1376840090 | Nathan Reed Hepner | Counselor | 600 W Morrison St, Suite 18, Fayette, MO 65248-1075 | 2011-02-15 |
| 1477855336 | Solcollin Aliscia Heard | Counselor | 600 W Morrison St, Ste. 18, Fayette, MO 65248-1075 | 2010-11-29 |
| 1992006399 | Leann Elizabeth Williams | Nurse Practitioner | 600 W Morrison St, Suite 5, Fayette, MO 65248-1075 | 2010-11-16 |
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| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801416599 | Ashlee Dougherty | Student in an Organized Health Care Education/Training Program | 1141 County Road 201, Fayette, MO 65248-9271 | 2020-04-22 |
| 1861966194 | Jenna Marie Elsbernd | Student in an Organized Health Care Education/Training Program | 605 Washington St, Fayette, IA 52142-9206 | 2019-01-21 |
| 1487166229 | Taylor Marie Patton | Student in an Organized Health Care Education/Training Program | 411 Central Methodist Sq, Fayette, MO 65248-1104 | 2017-11-02 |
| 1679013734 | Kelsey Sanders | Student in an Organized Health Care Education/Training Program | 605 Washington St, Fayette, IA 52142-9206 | 2017-03-08 |
| 1770023392 | Brieanna Barnes | Student in an Organized Health Care Education/Training Program | 605 Washington St, Fayette, IA 52142-9206 | 2017-03-01 |
| 1962942573 | Graham Werner | Student in an Organized Health Care Education/Training Program | 605 Washington St, Fayette, IA 52142-9206 | 2017-03-01 |
| 1871033480 | Caitlin Tarnowski | Student in an Organized Health Care Education/Training Program | 605 Washington St, Fayette, IA 52142-9206 | 2017-03-01 |
| 1174796171 | Teresa Maxine Kircher | Student in an Organized Health Care Education/Training Program | 411 Central Methodist Sq, Athletic Training Department, Fayette, MO 65248-1104 | 2008-04-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689272874 | Jacob Oliver Allen | Student in an Organized Health Care Education/Training Program | 3506 Frontier Dr, Saint Charles, MO 63303-6636 | 2020-10-11 |
| 1194323378 | Nicholas Andrews | Student in an Organized Health Care Education/Training Program | 2308 Sw Hawk View Rd, Lees Summit, MO 64082-4095 | 2020-10-11 |
| 1639777816 | Brittany Hodgman | Student in an Organized Health Care Education/Training Program | 1329 Governors Run Ct, O Fallon, MO 63366-5577 | 2020-10-11 |
| 1003423799 | Alexander Sextro | Student in an Organized Health Care Education/Training Program | 921 Saint Louis St, Florissant, MO 63031-4934 | 2020-09-26 |
| 1245845908 | Ali Hamzehloo | Student in an Organized Health Care Education/Training Program | 1155 Appleseed Ln Unit D, Saint Louis, MO 63132-3239 | 2020-09-10 |
| 1538773361 | Aarika Danielle Gardner | Student in an Organized Health Care Education/Training Program | 560 W Bryant Apt D207, Springfield, MO 65810-8329 | 2020-08-31 |
| 1801409545 | Hannah Walker | Student in an Organized Health Care Education/Training Program | 7507 Parkdale Ave Apt 3e, Clayton, MO 63105-2853 | 2020-08-24 |
| 1750993093 | Alyssa Brown | Student in an Organized Health Care Education/Training Program | 1444 Grand Blvd Apt 1201, Kansas City, MO 64106-2975 | 2020-08-18 |
| 1508475245 | Irfan Yasin | Student in an Organized Health Care Education/Training Program | 1402 S Grand Blvd Dept Of, Saint Louis, MO 63104-1004 | 2020-07-29 |
| 1174132948 | Trevor William Harvey | Student in an Organized Health Care Education/Training Program | 1908 E Parrin Ave, Ozark, MO 65721-4508 | 2020-07-28 |
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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.