FCC Medical Clinics LLC

PAC ID

1355743741The PECOS associate control ID: one enrolled organization, which may hold several NPIs

Provider type

Part A Provider - Rural Health Clinic, Part B Supplier - Clinic/Group Practice

Enrolled in

MO

Enrollments

2

Group size

3 cliniciansAs Care Compare reports it

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice locations

3In 2 places

Enrollment records 2

These NPI records belong to the same enrolled organization. Each has its own page.

• FCC Medical Clinics LLC

  dba FCC Primary Care Clinic

  • Rural Health Clinic/Center
  • Kennett, MO
  • NPI 1043885254
• FCC Medical Clinics LLC

  dba FCC Primary Care Clinic Poplar Bluff

  • Internal Medicine Physician
  • Poplar Bluff, MO
  • NPI 1215510490

Clinicians who reassign their Medicare benefits to this group (4) or whom Care Compare lists as members (3).

• Jennifer Leann Bader, FNP

  • Family Nurse Practitioner
  • Kennett, MO
  • NPI 1114277803
• Whitney Jo Bradford, APRN

  • Family Nurse Practitioner
  • Kennett, MO
  • NPI 1346736873
• Sarfaraz A Jasdanwala, MD

  • Internal Medicine Physician
  • Grand Rapids, MI
  • NPI 1851646665
• Karl Erik Shanstrom, DO

  • Family Medicine Physician
  • Kennett, MO
  • NPI 1689815201

• Medicare Fee-For-Service Public Provider Enrollment: the enrollments, PAC ID, practice locations and benefit reassignments.
• Care Compare Doctors and Clinicians: group membership, group size and the name CMS shows patients.
• NPPES NPI Registry: the names and addresses of the NPIs above.