Anthony Ezemba (NPI# 1336546084, PAC ID# 3274882774) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICAL MEDICINE AND REHABILITATION.
| Nation Provider ID (NPI) | 1336546084 |
| PAC ID by PECOS | 3274882774 |
| Professional Enrollment ID | I20180816001127 |
| Full Name | Anthony Ezemba |
| Organization Legal Name | PERFORMANCE PLUS REHABILITATION CENTER LLC |
| Address |
1802 N Woodbine Rd Saint Joseph MO 64506-3667 |
| Phone Number | 8162325113 |
| Gender | M |
| Graduation Year | 1999 |
| Primary Specialty | PHYSICAL MEDICINE AND REHABILITATION |
| Group Practice PAC ID | 5294791695 |
| Number of Group Practice Members | 21 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 260006 | MOSAIC LIFE CARE AT ST JOSEPH |
| Address | Phone | Organization |
|---|---|---|
| 1802 N Woodbine Rd, Saint Joseph, MO 64506-3667 | 8162325113 | PERFORMANCE PLUS REHABILITATION CENTER LLC |
| 5301 Faraon St, Suite 200, Saint Joseph, MO 64506-3829 | 8162717673 | HEARTLAND REGIONAL MEDICAL CENTER |
| Organization Legal Name | PERFORMANCE PLUS REHABILITATION CENTER LLC |
| Physicians | 22 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Luke J Brennan | Chiropractic | Performance Plus Rehabilitation Center LLC | 602 Lana Dr, Suite A, Cameron, MO 64429-1473 |
| Justin Richard Casey | Chiropractic | Performance Plus Rehabilitation Center LLC | 313 S 169 Hwy, Gower, MO 64454 |
| Joshua A Middendorf | Chiropractic | Performance Plus Rehabilitation Center LLC | 1802 N Woodbine Rd, Saint Joseph, MO 64506-3667 |
| Kathy F Darnell | Nurse Practitioner | Performance Plus Rehabilitation Center LLC | 1802 N Woodbine Rd, Saint Joseph, MO 64506-3667 |
| Allyn N Smith | Chiropractic | Performance Plus Rehabilitation Center LLC | 1802 N Woodbine Rd, Saint Joseph, MO 64506-3667 |
| James Gaunt | Otolaryngology | Performance Plus Rehabilitation Center LLC | 1802 N Woodbine Rd, Saint Joseph, MO 64506-3667 |
| Robert F Paul | Orthopedic Surgery | Performance Plus Rehabilitation Center LLC | 1802 N Woodbine Rd, Saint Joseph, MO 64506-3667 |
| Vikas Agarwal | Internal Medicine | Performance Plus Rehabilitation Center LLC | 1802 N Woodbine Rd, Saint Joseph, MO 64506-3667 |
| Steven D Brushwood | Family Medicine | Performance Plus Rehabilitation Center LLC | 1802 N Woodbine Rd, Saint Joseph, MO 64506-3667 |
| Randy S Buckles | Family Medicine | Performance Plus Rehabilitation Center LLC | 1802 N Woodbine Rd, Saint Joseph, MO 64506-3667 |
| Street Address |
1802 N WOODBINE RD |
| City | SAINT JOSEPH |
| State | MO |
| Zip | 64506-3667 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Joshua A Middendorf | Chiropractic | Performance Plus Rehabilitation Center LLC | 1802 N Woodbine Rd, Saint Joseph, MO 64506-3667 |
| Kathy F Darnell | Nurse Practitioner | Performance Plus Rehabilitation Center LLC | 1802 N Woodbine Rd, Saint Joseph, MO 64506-3667 |
| Allyn N Smith | Chiropractic | Performance Plus Rehabilitation Center LLC | 1802 N Woodbine Rd, Saint Joseph, MO 64506-3667 |
| James Gaunt | Otolaryngology | Performance Plus Rehabilitation Center LLC | 1802 N Woodbine Rd, Saint Joseph, MO 64506-3667 |
| Robert F Paul | Orthopedic Surgery | Performance Plus Rehabilitation Center LLC | 1802 N Woodbine Rd, Saint Joseph, MO 64506-3667 |
| Vikas Agarwal | Internal Medicine | Performance Plus Rehabilitation Center LLC | 1802 N Woodbine Rd, Saint Joseph, MO 64506-3667 |
| Steven D Brushwood | Family Medicine | Performance Plus Rehabilitation Center LLC | 1802 N Woodbine Rd, Saint Joseph, MO 64506-3667 |
| Randy S Buckles | Family Medicine | Performance Plus Rehabilitation Center LLC | 1802 N Woodbine Rd, Saint Joseph, MO 64506-3667 |
| Sarah R Wiederholt | Family Medicine | Performance Plus Rehabilitation Center LLC | 1802 N Woodbine Rd, Saint Joseph, MO 64506-3667 |
| Aaron Donald Jones | Physical Therapy | Performance Plus Rehabilitation Center LLC | 1802 N Woodbine Rd, Saint Joseph, MO 64506-3667 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Benjamin S Reine | Family Medicine | Heartland Regional Medical Center | 5210 N Belt Hwy Entrance C, Mosaic Life Care, St Joseph, MO 64506-1211 |
| Juan C Dominguez | Family Medicine | Heartland Regional Medical Center | 5204 N Belt Hwy Entrance A, Mosaic Life Care, St Joseph, MO 64506-1211 |
| Jonathan C Amspacher | Plastic and Reconstructive Surgery | Heartland Regional Medical Center | 5204 N Belt Hwy Entrance A, Mosaic Life Care, St Joseph, MO 64506-1211 |
| Melissa M Farris | Nurse Practitioner | Heartland Regional Medical Center | 5204 N Belt Hwy Entrance A, Mosaic Life Care, St Joseph, MO 64506-1211 |
| Davin G Turner | Family Medicine | Heartland Regional Medical Center | 5204 N Belt Hwy Entrance A, Mosaic Life Care, St Joseph, MO 64506-1211 |
| Cody D Hanson | Dermatology | Heartland Regional Medical Center | 5204 N Belt Hwy Entrance A, Mosaic Life Care, St Joseph, MO 64506-1211 |
| Alan W Brewer | Family Medicine | Heartland Regional Medical Center | 5204 N Belt Hwy Entrance A, Mosaic Life Care, St Joseph, MO 64506-1211 |
| Whitney B Atha | Nurse Practitioner | Heartland Regional Medical Center | 5204 N Belt Hwy Entrance A, Mosaic Life Care, St Joseph, MO 64506-1211 |
| James G Day | Family Medicine | Heartland Regional Medical Center | 5204 N Belt Hwy Entrance A, Mosaic Life Care, St Joseph, MO 64506-1211 |
| Ana M Liolios | Dermatology | Heartland Regional Medical Center | 5204 N Belt Hwy Entrance A, Mosaic Life Care, St Joseph, MO 64506-1211 |
| Find all physicians in zip 64506 | |||
| City | SAINT JOSEPH |
| Zip Code | 64506 |
| Specialty | PHYSICAL MEDICINE AND REHABILITATION |
| City + Specialty | SAINT JOSEPH + PHYSICAL MEDICINE AND REHABILITATION |
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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.