NPIMap

Organization Active NPI

Mercy Clinic Springfield Communities

Doing business as Eye Specialists-Optical Shop-Rolla

  • Durable Medical Equipment & Medical Supplies
  • Rolla, MO
National Provider Identifier
1023215571
Registry record updated Dec 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
MERCY CLINIC SPRINGFIELD COMMUNITIES
Practice address
1605 Martin Springs Dr
Suite 240a
Rolla, MO 65401-2931
Phone
(573) 458-6310
Fax
(573) 458-6791
NPI assigned
Jun 28, 2007
Last updated
Dec 11, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2023

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

Authorized official

Name
William J Roberts
Title
Cfo
Phone
(417) 820-7363

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X MO Primary

Addresses

Primary practice location

1605 Martin Springs Dr
Suite 240a
Rolla, MO 65401-2931

Mailing address

1605 Martin Springs Dr
Ste 240
Rolla, MO 65401-2982
Phone (417) 829-4215

Other names 1

  • Eye Specialists-Optical Shop-Rolla Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031218000354 MO Part B Supplier - Clinic/Group Practice 7416865845 Receives reassigned benefits from 1,639 practitioners
29 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
O20100930077278 MO DME Supplier - Physician - OptometristDME Supplier - Optician 7416865845 Practice locations: Rolla, MO

Other NPIs on the same Medicare enrollment 29

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 29

National Provider Directory

National Provider Directory
Tax ID family
St Johns Physicians Cli55 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 15

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 15

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1182988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702252800000",
    "number": "1023215571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1605 MARTIN SPRINGS DR",
            "address_2": "STE 240",
            "city": "ROLLA",
            "state": "MO",
            "postal_code": "654012982",
            "telephone_number": "417-829-4215",
            "fax_number": "417-829-4316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1605 MARTIN SPRINGS DR",
            "address_2": "SUITE 240A",
            "city": "ROLLA",
            "state": "MO",
            "postal_code": "654012931",
            "telephone_number": "573-458-6310",
            "fax_number": "573-458-6791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY CLINIC SPRINGFIELD COMMUNITIES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-28",
        "last_updated": "2023-12-11",
        "certification_date": "2023-12-11",
        "status": "A",
        "authorized_official_last_name": "ROBERTS",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "417-820-7363"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MO",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eye Specialists-Optical Shop-Rolla",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Eye Specialists-Optical Shop-Rolla",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Rolla, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2023; 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.