NPIMap

Organization Active NPI

Moberly Medical Clinics Inc

  • Radiology Clinic/Center
  • Moberly, MO
National Provider Identifier
1003226010
Registry record updated Jul 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology Clinic/CenterTaxonomy code 261QR0200X
Legal business name
MOBERLY MEDICAL CLINICS INC
Practice address
1509 Union Ave
Moberly, MO 65270-9407
Phone
(660) 263-8986
NPI assigned
Apr 29, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
James P Wright
Title
Sr. Director
Phone
(615) 465-7587

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiology Clinic/Center 261QR0200X Primary

Addresses

Primary practice location

1509 Union Ave
Moberly, MO 65270-9407

Mailing address

1509 Union Ave
Moberly, MO 65270-9407
Phone (660) 263-8986

Other names 1

  • Moberly Diagnostics Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140707000330 MO Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 8426031592 Practice locations: Moberly, MO

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Moberly Diagnostics2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

109 East St
Clarence, MO 63437
Phone (660) 699-2124

707 E Briggs Dr
Macon, MO 63552
Phone (660) 269-8752

1750 Omar Bradley Rd
Ste 200
Moberly, MO 65270
Phone (660) 263-3002

300 N Morley St
Ste A
Moberly, MO 65270
Phone (660) 263-1225

3100 Oak Grove Rd
Rombauer, MO 63901
Phone (573) 776-2000

136 Shelby Plaza Rd
Shelbina, MO 63468
Phone (573) 588-1111

Practitioners & affiliated clinicians

Practitioners 38

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 38

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1398729600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1404259200000",
    "number": "1003226010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1509 UNION AVE",
            "city": "MOBERLY",
            "state": "MO",
            "postal_code": "652709407",
            "telephone_number": "660-263-8986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1509 UNION AVE",
            "city": "MOBERLY",
            "state": "MO",
            "postal_code": "652709407",
            "telephone_number": "660-263-8986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOBERLY MEDICAL CLINICS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-29",
        "last_updated": "2014-07-02",
        "status": "A",
        "authorized_official_last_name": "WRIGHT",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "SR. DIRECTOR",
        "authorized_official_telephone_number": "615-465-7587"
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Moberly Diagnostics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Moberly, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.