CARONDELET PHYSICIAN SERVICES INC NPI 1811293582

NPI Information

  • NPI: 1811293582
  • Provider Name: CARONDELET PHYSICIAN SERVICES INC
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Organization
  • Other Name: OAK GROVE MEDICAL CLINIC
  • CLIA Number: 26D0443087
  • Address: 1900 S BROADWAY
    OAK GROVE, MO
    ZIP 64075
  • Phone: (816) 690-6566

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NPI Details

CARONDELET PHYSICIAN SERVICES INC is a family medicine in Oak Grove, MO. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. CARONDELET PHYSICIAN SERVICES INC NPI is 1811293582. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Other Name Is Oak Grove Medical Clinic.

The provider's business location address is:

1900 S BROADWAY
OAK GROVE, MO
ZIP 64075-020
Phone: (816) 690-6566
Fax: (816) 625-8276

The provider's authorized official is Steven R Cleary .
The authorized official title is Vp/cfo and has the following contact phone number (816) 943-2819.

The CLIA number assigned to this NPI record is 26D0443087 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/28/2011 and was last updated on 5/4/2011.

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
1207Q00000XFamily Medicine34421MISSOURIYes

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
139532013OTHERBCBS OF KANSAS CITY
2501269500MEDICAIDMISSOURI
3Y360000MEDICARE PINMISSOURI

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: 3/30/2025

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