Healthcare Provider Details

I. General information

NPI: 1932017589
Provider Name (Legal Business Name): WHEATON R-III SCHOOL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

116 MCCALL ST
WHEATON MO
64874-7701
US

IV. Provider business mailing address

116 MCCALL ST
WHEATON MO
64874-7701
US

V. Phone/Fax

Practice location:
  • Phone: 417-652-3914
  • Fax: 417-652-7355
Mailing address:
  • Phone: 417-652-3914
  • Fax: 417-652-7355

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number
License Number State

VIII. Authorized Official

Name: ROBERT CREEKMORE
Title or Position: DIRECTOR OF STUDENT SERVICES
Credential:
Phone: 417-652-3914