BURTON CREEK RURAL CLINIC LLC NPI 1720075161

NPI Information

NPI: 1720075161
Provider Name: BURTON CREEK RURAL CLINIC, LLC
Classification: Clinic/Center - 261QR1300X
Entity Type: Organization

Specialization: Rural Health

Address:
805 KENTUCKY AVE
WEST PLAINS, MO
ZIP 65775
Phone: (417) 256-2111
Get Directions

BURTON CREEK RURAL CLINIC, LLC is a rural health clinic center in West Plains, MO. BURTON CREEK RURAL CLINIC, LLC NPI is 1720075161. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

805 KENTUCKY AVE
WEST PLAINS, MO
ZIP 65775
Phone: (417) 256-2111
Fax: (417) 256-4858

The provider's authorized official is Tyler Thompson .
The authorized official title is Administrator and has the following contact phone number (417) 256-2111.

The enumeration date for this NPI number is 9/30/2005 and was last updated on 5/2/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207Q00000X	Family Medicine				No
2	261QR1300X	Clinic/Center	Rural Health			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	DC9179	OTHER		MEDICARE RR
2	599022308	MEDICAID	MISSOURI
3	509022307	MEDICAID	MISSOURI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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