Provider Demographics
NPI:1689820391
Name:SCHIMMEL, LORI M (DO)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:M
Last Name:SCHIMMEL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 MERCY WAY
Mailing Address - Street 2:
Mailing Address - City:JOPLIN
Mailing Address - State:MO
Mailing Address - Zip Code:64804-4524
Mailing Address - Country:US
Mailing Address - Phone:417-556-2300
Mailing Address - Fax:417-556-2906
Practice Address - Street 1:100 MERCY WAY
Practice Address - Street 2:
Practice Address - City:JOPLIN
Practice Address - State:MO
Practice Address - Zip Code:64804-4524
Practice Address - Country:US
Practice Address - Phone:417-556-2300
Practice Address - Fax:417-556-2906
Is Sole Proprietor?:No
Enumeration Date:2008-08-13
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2011014311207P00000X
OK4683207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200206700AMedicaid
MOP01513938OtherRAIL ROAD MEDICARE
KS201070870DMedicaid
MO1689820391Medicaid
MO1689820391Medicaid