Amy A Tally (NPI# 1518265941, PAC ID# 5698920700) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1518265941 |
| PAC ID by PECOS | 5698920700 |
| Professional Enrollment ID | I20130221000080 |
| Full Name | Amy A Tally |
| Organization Legal Name | NORTHWEST HEALTH SERVICES, INC. |
| Address |
1303 State St Mound City MO 64470-1717 |
| Phone Number | 6604425464 |
| Gender | F |
| Graduation Year | 2010 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 7113835174 |
| Number of Group Practice Members | 22 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 260006 | MOSAIC LIFE CARE AT ST JOSEPH |
| Address | Phone | Organization |
|---|---|---|
| 1303 State St, Mound City, MO 64470-1717 | 6604425464 | NORTHWEST HEALTH SERVICES, INC. |
| Organization Legal Name | NORTHWEST HEALTH SERVICES, INC. |
| Physicians | 5 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| James F Shelton | Family Practice | Northwest Health Services, Inc. | 1 Cross St, Hamilton, MO 64644-8312 |
| Helen M Skinner | Nurse Practitioner | Northwest Health Services, Inc. | 503 S 6th St, Downtown Health Center, St Joseph, MO 64501-2224 |
| Emad A Khan | Psychiatry | Northwest Health Services, Inc. | 5026 Faraon St, Saint Joseph, MO 64506-3375 |
| Michael H Stroud | Nurse Practitioner | Northwest Health Services, Inc. | 5026 Faraon St, Saint Joseph, MO 64506-3375 |
| Street Address |
1303 STATE ST |
| City | MOUND CITY |
| State | MO |
| Zip | 64470-1717 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Darci L Feiden | Nurse Practitioner | Northwest Health Services Inc | 1303 State St, Mound City, MO 64470-1717 |
| Tiffany L Bradbury | Nurse Practitioner | Northwest Health Services Inc | 1303 State St, Mound City, MO 64470-1717 |
| Tammy M Sparks | Nurse Practitioner | Northwest Health Services Inc | 1303 State St, Mound City, MO 64470-1717 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Rachel N Sharp | Chiropractic | 208 E 6th St, Mound City, MO 64470-1210 | |
| Michael Ml Krownapple | Psychologist, Clinical | Deer Oaks Mental Health Associates PC | 1531 Nebraska St, Tiffany Heights, Mound City, MO 64470-1610 |
| City | MOUND CITY |
| Zip Code | 64470 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | MOUND CITY + 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.