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PRIMARY CARE OF BONNE TERRE
NPI 1962883751
General Practice in Bonne Terre, MO

Active since June 17, 2015
527 BENHAM ST, BONNE TERRE, MO 63628(573) 358-9119(573) 358-9489 Get Directions Write a Review

NPPES record last updated: November 23, 2015. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Nov 23, 2015, Nov 18, 2015 (2 updates tracked since 2015).

About Primary Care Of Bonne Terre NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PRIMARY CARE OF BONNE TERRE (NPI 1962883751) is a healthcare organization registered as a general practice in Bonne Terre, Missouri and active in the NPI registry since June 2015. The organization lists Andrew J Ninichuck, Owner, as its authorized official.

NPPES Registry Identity

NPI1962883751
Entity TypeOrganization
Primary Taxonomy208D00000X
Legal Business NamePRIMARY CARE OF BONNE TERRE LLC
Location Address527 BENHAM STBonne Terre, MO 63628-1205
Mailing Address527 Benham StBonne Terre, MO 63628-1205 · (573) 358-9119 · Fax (573) 358-9489
Phone(573) 358-9119
Fax(573) 358-9489
Organization SubpartNo
Authorized OfficialAndrew J NinichuckOwner · (573) 358-9119
Enumeration DateJune 17, 2015
Last NPPES UpdateNovember 23, 20152 updates tracked since enumeration
✔ NPI 1962883751 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
Definition
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee
Also ListedClinic/Center · Primary CareTaxonomy 261QP2300X
527 BENHAM ST, Bonne Terre, MO 63628
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Other Names 1

Doing Business AsPrimary Care Of Bonne Terre

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. RONAY RODGERS FNP
Nurse Practitioner (Family)
527 BENHAM ST
BONNE TERRE, MO 63628
St. Francois County (573) 358-9119
MR. ANDREW JOHN NINICHUCK M.D.
General Practice
527 BENHAM ST
BONNE TERRE, MO 63628
St. Francois County (573) 358-9119
CONSTANCE L YOUNG FNP
Nurse Practitioner (Family)
527 BENHAM ST
BONNE TERRE, MO 63628
St. Francois County (573) 358-9119

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Primary Care Of Bonne Terre LLC's NPI number?

The NPI number for Primary Care Of Bonne Terre LLC is 1962883751. It was assigned to this organization in the NPPES registry on June 17, 2015. The provider is doing business as Primary Care Of Bonne Terre.

Where is Primary Care Of Bonne Terre LLC located?

Primary Care Of Bonne Terre LLC is located at 527 Benham St, Bonne Terre, MO 63628. The listed phone number is (573) 358-9119.

What is Primary Care Of Bonne Terre LLC's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

When was this NPI record last updated?

The NPPES record for Primary Care Of Bonne Terre LLC was last updated on November 23, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.