NRG-Parkland LLC

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

Legal business name

NRG-PARKLAND LLC

Practice address

1101 W Liberty St
Farmington, MO 63640-1921

Phone

(573) 756-6451

Fax

(573) 634-3349

NPI assigned

Feb 24, 2020

Organization subpart

No

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

Authorized official

Name

Debra Suzann Campbell

Title

Billing Manager

Phone

(573) 634-7155

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• David L Wells, MD

  • Diagnostic Radiology Physician
  • Plano, TX
  • NPI 1659447118

  MO

  Medicare reassignment Care Compare group NPD
• Alejandro Mendez Castillo, M.D.

  • Diagnostic Radiology Physician
  • Farmington, MO
  • NPI 1649255076
  Medicare reassignment Care Compare group
• Kenneth L Miller, MD

  • Diagnostic Radiology Physician
  • Farmington, MO
  • NPI 1992715122
  Medicare reassignment Care Compare group
• Gaspar Fernandez, MD

  • Diagnostic Radiology Physician
  • Springfield, IL
  • NPI 1750322319

  MO

  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1582502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582502400000",
    "number": "1902430481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 SOUTHWEST BLVD STE C",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651092501",
            "telephone_number": "573-634-7155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 W LIBERTY ST",
            "city": "FARMINGTON",
            "state": "MO",
            "postal_code": "636401921",
            "telephone_number": "573-756-6451",
            "fax_number": "573-634-3349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NRG-PARKLAND LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-24",
        "last_updated": "2020-02-24",
        "certification_date": "2020-02-24",
        "status": "A",
        "authorized_official_last_name": "CAMPBELL",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_middle_name": "SUZANN",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "573-634-7155"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "debbie@mboinc.com",
            "affiliation": "N",
            "endpointDescription": "Billing Department",
            "use": "DIRECT",
            "useDescription": "Direct",
            "useOtherDescription": "Jefferson City",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "VPN",
            "address_1": "1001 Southwest Blvd Ste C",
            "city": "Jefferson City",
            "state": "MO",
            "country_code": "US",
            "postal_code": "651092501",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kimberly Joyce Nicholson
• Rachael Lynn Nicholson, FNP
• Madalynn Jo Nigut, COTA/L
• Northland Hearing Center, Inc.
• Nra-Farmington, Missouri, LLC
• Marah J Null
• Amanda Lynn Nuyt, MPT
• Amber O'Neal
• Laura Oder
• Katie Odom, NP

• Diagnostic Radiology Physician in Farmington, MO
• Providers in Farmington, MO by specialty
• Diagnostic Radiology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2020; 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.