Armando R Favazza, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

R4884 Issued in MO

Practice address

1300 E Bradford Pkwy
Springfield, MO 65804-4264

Phone

(417) 761-5000

Fax

(417) 761-5111

NPI assigned

May 2, 2006

Last updated

Mar 11, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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

• Curators of the University of Missouri

  dba Mizzou Pharmacy - Southwest Blvd

  • Community/Retail Pharmacy
  • Jefferson City, MO
  • NPI 1740083641
  NPD (past)

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

{
    "created_epoch": "1146528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583884800000",
    "number": "1972561793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 E BRADFORD PKWY",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658044264",
            "telephone_number": "417-761-5000",
            "fax_number": "417-761-5111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 E BRADFORD PKWY",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658044264",
            "telephone_number": "417-761-5000",
            "fax_number": "417-761-5111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAVAZZA",
        "first_name": "ARMANDO",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-02",
        "last_updated": "2020-03-11",
        "certification_date": "2020-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MO",
            "license": "R4884",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200465805",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHOICE/BLUE SHIELD",
            "identifier": "3052",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "1545500",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KANSAS MEDICAID",
            "identifier": "2086351501",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "102461",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Fassnight Home Care and Respite LLC (Fassnight Home Care and Respite)
• Kenneth J Fattmann, MD
• Anna Faucett, IBCLC
• C Byron Faulkner, MD
• Frederick M. Faust, M.D.
• Kerri E Favrow, LPC
• Stacey L. Fawbush, FNP-C
• Monica Lynn Fawcett, MSN, APRN, FNP-BC
• Ian Lester Fawks, DO
• Ellie Marie Faxon, PA

• Psychiatry Physician in Springfield, MO
• Providers in Springfield, MO by specialty
• Psychiatry Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2020; 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.