Healthy Family Clinic, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

2002021764 Issued in MO

Legal business name

HEALTHY FAMILY CLINIC, LLC

Practice address

610 Rosewood Dr
Kirksville, MO 63501-2477

Phone

(660) 988-5770

NPI assigned

Jun 22, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Gemma Arbues Ciesemier, D.O.

Title

President

Phone

(660) 988-5770

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1308700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1316131200000",
    "number": "1689960239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 ROSEWOOD DR",
            "city": "KIRKSVILLE",
            "state": "MO",
            "postal_code": "635012477",
            "telephone_number": "660-988-5770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 ROSEWOOD DR",
            "city": "KIRKSVILLE",
            "state": "MO",
            "postal_code": "635012477",
            "telephone_number": "660-988-5770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHY FAMILY CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-22",
        "last_updated": "2011-09-16",
        "status": "A",
        "authorized_official_last_name": "CIESEMIER",
        "authorized_official_first_name": "GEMMA",
        "authorized_official_middle_name": "ARBUES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "660-988-5770",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2002021764",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Kirksville, MO
• Providers in Kirksville, MO by specialty
• Family Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2011; 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.