St. John'S Physicians & Clinics, Inc.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

ST. JOHN'S PHYSICIANS & CLINICS, INC.

Doing business as

SJC-Rolla Family Medicine

Practice address

1605 Martin Springs Dr
Suite 210
Rolla, MO 65401-2931

Phone

(573) 458-6326

Fax

(573) 458-6763

NPI assigned

Jun 25, 2007

Organization subpart

No

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

Authorized official

Name

Vickie Jenkins

Title

Provider Enrollment Coordinator

Phone

(417) 829-4264

Specialties & licenses 1

Addresses

Other names 1

• SJC-Rolla Family Medicine Doing business as

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

{
    "created_epoch": "1182729600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1275436800000",
    "number": "1033315148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2580",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658012580",
            "telephone_number": "417-829-4620",
            "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 210",
            "city": "ROLLA",
            "state": "MO",
            "postal_code": "654012931",
            "telephone_number": "573-458-6326",
            "fax_number": "573-458-6763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. JOHN'S PHYSICIANS & CLINICS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-25",
        "last_updated": "2010-06-02",
        "status": "A",
        "authorized_official_last_name": "JENKINS",
        "authorized_official_first_name": "VICKIE",
        "authorized_official_title_or_position": "PROVIDER ENROLLMENT COORDINATOR",
        "authorized_official_telephone_number": "417-829-4264"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MO",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SJC-Rolla Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sport Rehab, Inc.
• Springfield Neurological and Spine Institute
• Luther D. Spurlock, MD
• SRZ Op Rolla LLC
• St. John'S Clinic Inc
• Patrecia P Stamper, P.T.A.
• State of Missouri
• State of Missouri
• Kathy Stavropoulos, PLPC
• Aubrie Kay Stephens

• Durable Medical Equipment & Medical Supplies in Rolla, MO
• Providers in Rolla, MO by specialty
• Durable Medical Equipment & Medical Supplies in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.