Amy B Willbanks (NPI# 1417222175, PAC ID# 0143475756) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1417222175 |
| PAC ID by PECOS | 0143475756 |
| Professional Enrollment ID | I20130306000064 |
| Full Name | Amy B Willbanks |
| Organization Legal Name | SSM ST.CHARLES CLINIC MEDICAL GROUP INC |
| Address |
1551 Wall St Suite 400 St Charles MO 63303-2597 |
| Phone Number | 6366692434 |
| Gender | F |
| Graduation Year | 2002 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 9032023304 |
| Number of Group Practice Members | 132 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 260200 | SSM HEALTH SAINT JOSEPH HOSPITAL-LAKE SAINT LOUIS |
| 260005 | SSM HEALTH ST JOSEPH HOSPITAL-ST CHARLES |
| Address | Phone | Organization |
|---|---|---|
| 1551 Wall St, Suite 400, St Charles, MO 63303-2597 | 6366692434 | SSM ST.CHARLES CLINIC MEDICAL GROUP INC |
| 1551 Wall St, St Charles, MO 63303-2597 | 6366692434 | SSM ST.CHARLES CLINIC MEDICAL GROUP INC |
| Organization Legal Name | SSM ST.CHARLES CLINIC MEDICAL GROUP INC |
| Physicians | 8 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Anthony W Campbell | General Surgery | Ssm St.charles Clinic Medical Group Inc | 400 1st Capitol Dr, Suite 201, Saint Charles, MO 63301-2882 |
| Pedro C Padilla | Urology | Ssm St.charles Clinic Medical Group Inc | 300 Medical Plz, Suite 310, Lake St Louis, MO 63367-1484 |
| Anna C Wolaniuk | Obstetrics/gynecology | Ssm St.charles Clinic Medical Group Inc | 1475 Kisker Rd, Saint Charles, MO 63304-8788 |
| Laura A Benack | Nurse Practitioner | Ssm St.charles Clinic Medical Group Inc | 6994 Mexico Rd, St Peters, MO 63376-1512 |
| Erika R Anderson | Physician Assistant | Ssm St.charles Clinic Medical Group Inc | 300 Medical Plz, Suite 310, Lake St Louis, MO 63367-1484 |
| Renee L Mcdonald | Nurse Practitioner | Ssm St.charles Clinic Medical Group Inc | 300 Medical Plz, Suite 150, Lake Saint Louis, MO 63367-1483 |
| Martin P Altman | Gastroenterology | Ssm St.charles Clinic Medical Group Inc | 1551 Wall St, Suite 400, St Charles, MO 63303-2597 |
| Street Address |
1551 WALL ST SUITE 400 |
| City | ST CHARLES |
| State | MO |
| Zip | 63303-2597 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Erin Rice Fick | Internal Medicine | American Multispecialty Group Inc | 1551 Wall St, Suite 400, Saint Charles, MO 63303-3541 |
| Elizabeth Hudgins Maylack | Family Medicine | American Multispecialty Group Inc | 1551 Wall St, Suite 400, Saint Charles, MO 63303-3541 |
| Homer T Johnson Ii | Sleep Medicine | Ssm Medical Group Inc | 1551 Wall St, Saint Charles, MO 63303-3539 |
| Martin P Altman | Gastroenterology | Ssm St.charles Clinic Medical Group Inc | 1551 Wall St, Suite 400, St Charles, MO 63303-2597 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Rachel H Smith | Nurse Practitioner | Ssm Medical Group Inc | 2310 S Old Hwy 94, Ssm Health Medical Grp, St Charles, MO 63303 |
| Omar Ahmad Mahmood | Diagnostic Radiology | Red River Consultants Inc | 10 Maryells Way, Saint Charles, MO 63303-1348 |
| Kathleen M Uhlig | Physical Therapy | Prorehab PC | 2053 Zumbehl Rd, Saint Charles, MO 63303-2723 |
| Rachel E Merriman | Optometry | Kwiatek Optometry Associates PC | 2035 Zumbehl Rd, Saint Charles, MO 63303-2723 |
| Stephen Mccullough | Optometry | Kwiatek Optometry Associates PC | 2035 Zumbehl Rd, Saint Charles, MO 63303-2723 |
| Alan S Kwiatek | Optometry | Kwiatek Optometry Associates PC | 2035 Zumbehl Rd, Saint Charles, MO 63303-2723 |
| David A Horton | Physical Therapy | Prorehab PC | 2053 Zumbehl Rd, Saint Charles, MO 63303-2723 |
| Mary J Bennett | Optometry | Kwiatek Optometry Associates PC | 2035 Zumbehl Rd, Saint Charles, MO 63303-2723 |
| Steven Douglas Warden | Physical Therapy | Prorehab PC | 2053 Zumbehl Rd, Saint Charles, MO 63303-2723 |
| Edwina Fay Spence | Nurse Practitioner | American Current Care of Kansas Pa | 1794 Zumbehl Rd, Saint Charles, MO 63303-2759 |
| Find all physicians in zip 63303 | |||
| City | ST CHARLES |
| Zip Code | 63303 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | ST CHARLES + NURSE PRACTITIONER |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.