BRYAR A BEQUETTE (NPI# 1972161206) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972161206 |
| Entity Type | Individual |
| Full Name | BRYAR A BEQUETTE |
| Credential | PA-C |
| Practice Address |
452 Sovereign Ct Ballwin MO 63011-4447 |
| Practice Telephone | 3142386527 |
| Mailing Telephone | 3142386527 |
| Enumeration Date | 2019-06-01 |
| Last Update Date | 2019-06-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
2019017143 | MO | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
452 SOVEREIGN CT |
| City | BALLWIN |
| State | MO |
| Zip Code | 63011-4447 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801459052 | Liliana Ungureanu | Nurse Practitioner | 452 Sovereign Ct, Ballwin, MO 63011-4447 | 2019-04-15 |
| 1871103093 | Amanda Bertholomey | Nurse Practitioner | 452 Sovereign Ct, Ballwin, MO 63011-4447 | 2020-08-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205309234 | Heather Renee Leone | Nurse Practitioner | 452 Sovereign Court Suite A, Ballwin, MO 63011 | 2019-01-02 |
| 1538635297 | Jennifer Lea Nicole O'donnell | Registered Nurse | 13861 Manchester Road, Town and Country, MO 63011 | 2018-10-22 |
| 1285127712 | Genevieve Friedmann | Social Worker | 301 Sovereign Ct Ste 103, Ballwin, MO 63011 | 2018-06-09 |
| 1881187391 | Andrew Cittadino Link | Dentist | 14335 Manchester Road, Ballwin, MO 63011 | 2018-06-08 |
| 1972041283 | Anavan LLC | Durable Medical Equipment & Medical Supplies | 14390 Manchester Rd, Saint Louis, MO 63011 | 2017-02-07 |
| 1780131300 | Autism and Behavioral Spectrum LLC | Day Training, Developmentally Disabled Services | 14733 Clayton Road, Chesterfield, MO 63011 | 2016-09-01 |
| 1265872964 | Eryn Nichole Miner | Behavioral Analyst | 15834 Clayton Road, Ellisville, MO 63011 | 2013-06-27 |
| 1194168765 | Donna Margaret Carrillo | Developmental Therapist | 15834 Clayton Rd., Ellisville, MO 63011 | 2013-04-12 |
| 1891047486 | Ashley Amanda Battaglia | Chiropractor | 15945 Clayton Rd Ste 230c, Ballwin, MO 63011 | 2012-10-08 |
| 1750658480 | Gary Frank Sobocinski | Pharmacist | 4033 Sovereign Court, Ballwin, MO 63011 | 2011-11-23 |
| Find all providers in zip 63011 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639785470 | Elias Helal | Physician Assistant | 452 Sovereign Ct Ste A, Ballwin, MO 63011-4447 | 2020-09-17 |
| 1144786351 | David Fisher | Physician Assistant | 13861 Manchester Rd, Ballwin, MO 63011-4503 | 2019-02-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922628528 | Sarah Benson | Physician Assistant | 26791 Andrews Ln, Warrenton, MO 63383-6240 | 2020-04-23 |
| 1154956498 | Ashleigh Clendenny | Physician Assistant | Mercy Hospital St. Louis, 615 S New Ballas Rd, St. Louis, MO 63141 | 2020-03-06 |
| 1912538752 | Karen Anghel | Physician Assistant | 804 S Kisner Dr, Independence, MO 64056-3062 | 2020-01-30 |
| 1457822082 | Jwan Alallaf | Physician Assistant | 4121 Roanoke Rd Apt 18, Kansas City, MO 64111-4053 | 2018-12-07 |
| 1730602921 | Saurav N Kayastha | Physician Assistant | 13013 Fuller Ave Ste A, Grandview, MO 64030-2687 | 2017-07-19 |
| 1891227393 | Hollis Smith | Physician Assistant | 2015 Maplewood Commons Dr, Saint Louis, MO 63143-1003 | 2017-04-03 |
| 1992165104 | Cassie Mcgee | Physician Assistant | 1051 Jones St, Kennett, MO 63857-3866 | 2016-03-01 |
| 1033462387 | Miguel Angel Medina | Physician Assistant | 1900 South Sunshine Ave., Springfield, MO 65807 | 2012-10-24 |
| 1699084814 | Travis James Weiss | Physician Assistant | 6724 State Highway 77, Benton, MO 63736-8238 | 2010-10-05 |
| 1235453150 | James F Patton | Physician Assistant | 913 South St, Stockton, MO 65785-9381 | 2010-03-22 |
| Find all providers with the same taxonomy | ||||
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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.