Nicole Renee Medley, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2008015945 Issued in MO

Practice address

821 Westwood Dr
Sedalia, MO 65301-2102

Phone

(660) 826-4774

Fax

(660) 826-1300

NPI assigned

Jul 23, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Nicole Renee Ghanem Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Networks

• IA HMO C-SNP

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Medley Sleeps, LLC

  • Customized Equipment (DME)
  • Independence, MO
  • NPI 1972294726
  NPD Authorized official
• Sleep Impressions, LLC

  • Specialist
  • Saint Louis, MO
  • NPI 1134547912
  NPD (past)

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

{
    "created_epoch": "1216771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329955200000",
    "number": "1053576629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "821 WESTWOOD DR",
            "city": "SEDALIA",
            "state": "MO",
            "postal_code": "653012102",
            "telephone_number": "660-826-4774",
            "fax_number": "660-826-1300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "821 WESTWOOD DR",
            "city": "SEDALIA",
            "state": "MO",
            "postal_code": "653012102",
            "telephone_number": "660-826-4774",
            "fax_number": "660-826-1300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDLEY",
        "first_name": "NICOLE",
        "middle_name": "RENEE",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-23",
        "last_updated": "2012-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "2008015945",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "GHANEM",
            "middle_name": "RENEE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Casey Eisenhower McCluskie, DC
• Maureen Ann McConnell, PT
• Frances H McKee, APRN, FNP-C
• Patricia Kay McKinney
• McWhirt-Gibson Incorporation
• Mefford Vuagniaux & Associates
• Thomas Michael Mefford, M.S.
• Menm, LLC
• Sonya L Mertgen, OTR L
• Robert E Messerli, LPC

• General Practice Dentistry in Sedalia, MO
• Providers in Sedalia, MO by specialty
• General Practice Dentistry in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.