Annex Luberisse, ND
Individual provider Active NPI Naturopath · Marshall, MO
NPI 1104255843 · NPPES record last updated Nov 4, 2013
Key facts
- NPI
- 1104255843
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Naturopath 175F00000X
- Practice address
- 1674 S Odell Ave # B
Marshall, MO 65340-3365 - Phone
- (660) 229-0858
- NPI assigned
- Nov 4, 2013
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| A Pattern Health Clinic, Inc | Current | Accepting new patients | |
| A Pattern Medical Clinic | Current | Accepting new patients |
Locations
1674 S Odell Ave
#B
Marshall, MO 65340
Phone (660) 229-0858
Interoperability endpoints
- https://api.platform.athenahealth.com/24451/brand/1/csg/1/fhir/r4
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Naturopath | 175F00000X | Yes |
Addresses
Primary practice location
1674 S Odell Ave # B
Marshall, MO 65340-3365
Mailing address
1674 S Odell Ave # B
Marshall, MO 65340-3365
Phone (660) 229-0858
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710320643 | Other | NPI | |
| MA4558 | Other | PTAN |
Other providers in Marshall, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 4, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.