Debra A Atkinson, MD
Individual provider Active NPI Family Medicine Physician · Lake Ozark, MO
NPI 1376515080 · NPPES record last updated Jul 14, 2023
Key facts
- NPI
- 1376515080
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 2000162958 (MO)
- Practice address
- 1870 Bagnell Dam Blvd
Lake Ozark, MO 65049-8658 - Phone
- (573) 365-2318
- Fax
- (573) 365-3009
- NPI assigned
- Feb 6, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2000162958 | MO | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cherry Creek Family Practice PLLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 2000162958 | MO | Yes |
Addresses
Primary practice location
1870 Bagnell Dam Blvd
Lake Ozark, MO 65049-8658
Mailing address
67 Silver Creek LN
Eldon, MO 65026-5430
Phone (573) 280-0672
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 130110 | Other | BLUE CROSS BLUE SHIELD | |
| 937875 | Other | FIRST HEALTH | |
| 205061104 | Medicaid | MO | |
| MA4964061 | Other | MO | MEDICARE PTAN |
| 080165723 | Other | RR MEDICARE | |
| 3156281 | Other | CIGNA | |
| 438746 | Other | HEALTHLINK | |
| 440546366 | Other | UNITED HEALTHCARE | |
| G25024 | Other | MERCY |
Other names
- Debra A Cada
Other providers in Lake Ozark, MO
- Terell Adetunji
- Dennis L Albers
- Taylor Nicolle Ash
- B &B Eyecare, LLC
- Mark Roy Bagby
- Stephanie Ballard
- Sara Barlett
- Barnes Medical Clinic PC
All providers in Lake Ozark, MO · Family Medicine Physician in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 14, 2023. 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.