Missouri Medical Providers LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

MISSOURI MEDICAL PROVIDERS LLC

Doing business as

Solutions Medical Provider Services

Practice address

2215 Broadway St
Cape Girardeau, MO 63701-4403

Phone

(636) 725-1255

Fax

(573) 534-3131

NPI assigned

Oct 8, 2020

Last updated

Apr 13, 2026By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Omer Malik

Title

Owner

Phone

(573) 382-3301

Specialties & licenses 4

Addresses

Other identifiers 2

Other names 1

• Solutions Medical Provider Services Doing business as

Medicare fee-for-service enrollment

Enrolled in MO, IL2 enrollments

Enrollment records 2

Locations

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Shannon Michelle Bay, FNP

  • Family Nurse Practitioner
  • Festus, MO
  • NPI 1992367213
  Medicare reassignment Care Compare group NPD
• Ilunga Katambwa, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Saint Louis, MO
  • NPI 1104400837

  Family

  Medicare reassignment Care Compare group NPD
• Catherine Nailaen Mepukori, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Saint Charles, MO
  • NPI 1003514563

  IL

  Medicare reassignment Care Compare group NPD
• Leslie Joan Desha, FNP

  • Family Nurse Practitioner
  • Columbia, MO
  • NPI 1114526266
  Medicare reassignment Care Compare group
• Samad Faheem, DO

  • Hospitalist Physician
  • McHenry, IL
  • NPI 1821522004

  MO

  Medicare reassignment NPD
• Emmanuelson Chukwuyem, APRN

  • Family Nurse Practitioner
  • Weldon Spring, MO
  • NPI 1275396376
  Medicare reassignment
• Leah Bennett

  • Family Nurse Practitioner
  • Festus, MO
  • NPI 1649069915
  NPD
• Kati Danielle Hinkle, F.N.P

  • Family Nurse Practitioner
  • Salem, MO
  • NPI 1588005599
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1602115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776038400000",
    "number": "1043817323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2215 BROADWAY ST",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637014403",
            "telephone_number": "636-725-1255",
            "fax_number": "573-534-3131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2215 BROADWAY ST",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637014403",
            "telephone_number": "636-725-1255",
            "fax_number": "573-534-3131"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 Calvary Church Rd",
            "address_purpose": "LOCATION",
            "city": "Festus",
            "state": "MO",
            "postal_code": "630284125",
            "country_code": "US",
            "telephone_number": "573-271-5317",
            "fax_number": "573-335-6724",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1349 US Highway 61",
            "address_purpose": "LOCATION",
            "city": "Festus",
            "state": "MO",
            "postal_code": "630284107",
            "country_code": "US",
            "telephone_number": "636-937-3500",
            "fax_number": "636-931-2646",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2001 N Kingshighway St",
            "address_purpose": "LOCATION",
            "city": "Cape Girardeau",
            "state": "MO",
            "postal_code": "637012127",
            "country_code": "US",
            "telephone_number": "573-335-1999",
            "fax_number": "573-335-1997",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10 Lake Dr",
            "address_purpose": "LOCATION",
            "city": "Bonne Terre",
            "state": "MO",
            "postal_code": "636281820",
            "country_code": "US",
            "telephone_number": "573-358-2800",
            "fax_number": "573-358-1090",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "783 Weber Rd",
            "address_purpose": "LOCATION",
            "city": "Farmington",
            "state": "MO",
            "postal_code": "636403318",
            "country_code": "US",
            "telephone_number": "573-756-1574",
            "fax_number": "573-756-1577",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1100 Progress Pkwy",
            "address_purpose": "LOCATION",
            "city": "Ste Genevieve",
            "state": "MO",
            "postal_code": "636709232",
            "country_code": "US",
            "telephone_number": "573-883-3500",
            "fax_number": "573-883-7673",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5408 S Broadway",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631112023",
            "country_code": "US",
            "telephone_number": "573-271-5317",
            "fax_number": "573-335-6724",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "202 S West St",
            "address_purpose": "LOCATION",
            "city": "Concordia",
            "state": "MO",
            "postal_code": "640209643",
            "country_code": "US",
            "telephone_number": "660-463-2267",
            "fax_number": "573-335-6724",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MISSOURI MEDICAL PROVIDERS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-08",
        "last_updated": "2026-04-13",
        "certification_date": "2026-04-13",
        "status": "A",
        "authorized_official_last_name": "MALIK",
        "authorized_official_first_name": "OMER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "573-382-3301"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "163WW0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Wound Care",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1043817323",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500090302",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Solutions Medical Provider Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Raven Mitchell

• Family Nurse Practitioner in Cape Girardeau, MO
• Providers in Cape Girardeau, MO by specialty
• Family Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.