DR. BRUCE L HEDGEPETH (NPI# 1942269733) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942269733 |
| Entity Type | Individual |
| Full Name | DR. BRUCE L HEDGEPETH |
| Credential | MD |
| Practice Address |
1000 W 10th St Rolla MO 65401-2905 |
| Practice Telephone | 5733649000 |
| Practice Fax Number | 5734588396 |
| Mailing Telephone | 5733649000 |
| Mailing Fax Number | 5734588396 |
| Enumeration Date | 2006-03-21 |
| Last Update Date | 2019-07-02 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207U00000X | Nuclear Medicine | 107692 | MO | Allopathic & Osteopathic Physicians |
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
107692 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 207965302 | 05 | |
| IL | ENROLLED | 05 |
| Street Address |
1000 W 10TH ST |
| City | ROLLA |
| State | MO |
| Zip Code | 65401-2905 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578559076 | Phelps County Regional Medical Center | Skilled Nursing Facility | 1000 W 10th St, Rolla, MO 65401-2905 | 2005-09-21 |
| 1770192957 | Brandon Lamberth | Nurse Practitioner | 1000 W 10th St, Rolla, MO 65401-2905 | 2020-07-23 |
| 1669026670 | Patricia Lou Cox | Registered Nurse | 1000 W 10th St, Rolla, MO 65401-2905 | 2019-07-29 |
| 1811555477 | Charles Joseph Krone | Anesthesiology | 1000 W 10th St, Rolla, MO 65401-2905 | 2019-05-30 |
| 1194383711 | Collin Dobson | Nurse Anesthetist, Certified Registered | 1000 W 10th St, Rolla, MO 65401-2905 | 2019-05-29 |
| 1104483718 | Blaine Goodman | Nurse Anesthetist, Certified Registered | 1000 W 10th St, Rolla, MO 65401-2905 | 2019-05-20 |
| 1780247320 | Ryan James Ballard | Nurse Anesthetist, Certified Registered | 1000 W 10th St, Rolla, MO 65401-2905 | 2019-04-18 |
| 1205304300 | Miracl, LLC | Clinic/Center | 1000 W 10th St, Rolla, MO 65401-2905 | 2018-11-06 |
| 1386142685 | Rachel Nacole Clark | Physician Assistant | 1000 W 10th St, Rolla, MO 65401-2905 | 2018-02-01 |
| 1629588314 | Patricia Ann French | Nurse Practitioner | 1000 W 10th St, Rolla, MO 65401 | 2017-10-06 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639645591 | Samantha Jo Mitchell | Pharmacist | 1375 E 10th St Suite B, Rolla, MO 65401 | 2018-10-18 |
| 1427567726 | Gerry Wade Funkhouser Jr. | Counselor | 103 W 10th St, Rolla, MO 65401 | 2017-09-29 |
| 1366967960 | Shana Hintz Wisniewski | Social Worker | 1000 W. 10th St., Rolla, MO 65401 | 2017-08-04 |
| 1174066559 | Tabitha Hundt | Counselor | 1011 Cypress Dr, Rolla, MO 65401 | 2016-12-02 |
| 1841742855 | Alpha Assisted Living LLC | Assisted Living Facility | 13450 Cr 7040, 803 E 12th St, Rolla, MO 65401 | 2016-10-26 |
| 1275916884 | Elizabeth Zersen | Occupational Therapist | 2053 Vienna Rd, Rolla, MO 65401 | 2015-06-30 |
| 1386047025 | Becky L Witham | Nurse Practitioner | 1060 W 10th Street, Rolla, MO 65401 | 2014-10-08 |
| 1114326121 | Summer Adey | Licensed Practical Nurse | 13750 State Route F, Rolla, MO 65401 | 2014-08-14 |
| 1518303296 | Leaetta Mildred Gardner | Nursing Facility/Intermediate Care Facility | 13450 County Road 7040, Rolla, MO 65401 | 2013-05-21 |
| 1316282064 | Susan Peitz Gruener | Occupational Therapy Assistant | 1800 White Column Road, Rolla, MO 65401 | 2012-12-06 |
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| Taxonomy Code | 207U00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Nuclear Medicine |
| A nuclear medicine specialist employs the properties of radioactive atoms and molecules in the diagnosis and treatment of disease and in research. Radiation detection and imaging instrument systems are used to detect disease as it changes the function and metabolism of normal cells, tissues and organs. A wide variety of diseases can be found in this way, usually before the structure of the organ involved by the disease can be seen to be abnormal by any other techniques. Early detection of coronary artery disease (including acute heart attack), early cancer detection and evaluation of the effect of tumor treatment, diagnosis of infection and inflammation anywhere in the body and early detection of blood clot in the lungs are all possible with these techniques. Unique forms of radioactive molecules can attack and kill cancer cells (e.g., lymphoma, thyroid cancer) or can relieve the severe pain of cancer that has spread to bone |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Nuclear Medicine, 2007. http://www.abnm.org/. A doctor of osteopathy was able to obtain a Certificate of Added Qualifications in the field of Nuclear Medicine. The Certificate is NO longer offered. - American Osteopathic Board of Nuclear Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Nuclear Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477890184 | Syed Sertaj Akhtar | Nuclear Medicine | 1045 Pinegate Dr, Saint Louis, MO 63122-2409 | 2013-01-15 |
| 1932473766 | George P Wilson | Nuclear Medicine | 4402 Glen Eagle Dr, Columbia, MO 65203-4834 | 2012-02-24 |
| 1740306067 | Asif Moinuddin | Nuclear Medicine | 8985 S Swan Cir, Saint Louis, MO 63144-1717 | 2007-03-21 |
| 1902442650 | Amir Iravani Tabrizipour | Nuclear Medicine | 510 S Kingshighway Blvd, Saint Louis, MO 63110-1016 | 2019-11-18 |
| 1942850078 | Paul-robert Derenoncourt | Nuclear Medicine | 510 S Kingshighway Blvd, Saint Louis, MO 63110-1016 | 2019-09-20 |
| 1750728192 | Malak Itani | Nuclear Medicine | 510 S Kingshighway Blvd, Saint Louis, MO 63110-1016 | 2013-05-24 |
| 1962750265 | Rashmi Jain | Nuclear Medicine | 615 S New Ballas Rd, Dept of Nuclear Medicine/radiology, Saint Louis, MO 63141-8221 | 2012-08-17 |
| 1407118318 | Michael S. Moritz | Nuclear Medicine | 615 S New Ballas Rd, Saint Louis, MO 63141 | 2012-06-15 |
| 1104132331 | Garima Agrawal | Nuclear Medicine | 660 S Euclid Ave, Cmps Box 8131, Wash Univ-dept of Nuclear Medicine, Saint Louis, MO 63110-1010 | 2010-08-25 |
| 1154549459 | St Louis University | Nuclear Medicine | 3635 Vista Ave, Saint Louis, MO 63110-2539 | 2007-04-23 |
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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.