Primary Care of Bonne Terre LLC
NPI 1962883751ActiveOrganization· General Practice· Bonne Terre, MO
General Practice in Bonne Terre, Missouri, registered in NPPES in June 2015. The authorized official on file is Andrew J. Ninichuck, MD, Owner. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1962883751 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jun 17, 2015 |
| Last updated in NPPES | Nov 23, 2015 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| General Practice Primary | 208D00000X | — | — |
| Clinic/Center, Primary Care | 261QP2300X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (MO) |
|---|
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