MERCY CLINIC SPRINGFIELD COMMUNITIES NPI 1962534727

NPI Information

NPI: 1962534727
Provider Name: MERCY CLINIC SPRINGFIELD COMMUNITIES

Doing Business As: MERCY CLINIC FAMILY MEDICINE-REPUBLIC

Classification: Clinic/Center - 261QR1300X
Entity Type: Organization

Specialization: Rural Health

Address:
332 S MAIN AVE
REPUBLIC, MO
ZIP 65738
Phone: (417) 732-5050
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MERCY CLINIC SPRINGFIELD COMMUNITIES is a rural health clinic center in Republic, MO. MERCY CLINIC SPRINGFIELD COMMUNITIES NPI is 1962534727. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Mercy Clinic Family Medicine-republic.

The provider's business location address is:

332 S MAIN AVE
REPUBLIC, MO
ZIP 65738
Phone: (417) 732-5050
Fax: (417) 732-8061

The provider's authorized official is Stuart Stangeland .
The authorized official title is Senior Vice President and has the following contact phone number (417) 820-3873.

The CLIA number assigned to this NPI record is 26D0903120 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/9/2007 and was last updated on 6/11/2018.

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		107047	MISSOURI	No
2	363A00000X	Physician Assistant		2001029957	MISSOURI	No
3	363LF0000X	Nurse Practitioner	Family	145564	MISSOURI	No
4	261QR1300X	Clinic/Center	Rural Health		MISSOURI	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	596051300	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

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