MEDICARE: NEEMA JOHN MUSHI

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	374U00000X	Home Health Aide		MO

General Provider Information

NPI Number	:	1902768310
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NEEMA JOHN MUSHI

Provider Business Mailing Address
First Line	:	8863 NEW ATHENS DARMSTADT RD
Second Line	:
City	:	NEW ATHENS
State	:	IL
Zip	:	62264-2705
Country	:	US
Telephone Number	:	319-300-0095
Fax Number	:	319-300-0095

Provider Business Practice Location Address
First Line	:	8811 NORTHCREST LN
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63147-1437
Country	:	US
Telephone Number	:	319-300-0095
Fax Number	:	319-300-0095

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/25/2025
Last Update Date	:	11/25/2025

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