NPIMap

Organization Active NPI

McPherson Medical & Diagnostic, LLC

Doing business as Hayti Medical & Diagnostic

  • Clinic/Center
  • Hayti, MO
National Provider Identifier
1073154019
Registry record updated Oct 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
MCPHERSON MEDICAL & DIAGNOSTIC, LLC
Doing business as
Hayti Medical & Diagnostic
Practice address
223 S 3Rd St
Hayti, MO 63851-1617
Phone
(573) 717-1072
NPI assigned
Oct 1, 2019
Last updated
Oct 1, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2019

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

Authorized official

Name
Timothy William McPhersonNPI 1245264696
Title
Ceo
Phone
(573) 695-2181

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

223 S 3Rd St
Hayti, MO 63851-1617

Mailing address

PO Box 12545
Belfast, ME 04915-4016
Phone (573) 717-1072

Other names 1

  • Hayti Medical & Diagnostic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, AR2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20061201000167 MO Part B Supplier - Clinic/Group Practice 5698773539 Receives reassigned benefits from 116 practitioners
23 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Kennett, MO; Macon, MO; Malden, MO; Saint Louis, MO; Saint Peters, MO; Scott City, MO; Steele, MO; Moberly, MO…
O20200723000803 AR Part B Supplier - Clinic/Group Practice 5698773539 Receives reassigned benefits from 3 practitioners
Practice locations: Blytheville, AR

Other NPIs with the same Medicare PAC ID 10

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

Other NPIs on the same Medicare enrollment 23

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

View all 23

National Provider Directory

National Provider Directory
Tax ID family
American Medical Missouri37 organizations share this tax ID, including this one

Other organizations with this tax ID 36

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

View all 36

Practitioners & affiliated clinicians

Practitioners 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1569888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1569888000000",
    "number": "1073154019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12545",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049154016",
            "telephone_number": "573-717-1072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "223 S 3RD ST",
            "city": "HAYTI",
            "state": "MO",
            "postal_code": "638511617",
            "telephone_number": "573-717-1072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCPHERSON MEDICAL & DIAGNOSTIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-01",
        "last_updated": "2019-10-01",
        "status": "A",
        "authorized_official_last_name": "MCPHERSON",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "573-695-2181"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hayti Medical & Diagnostic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hayti, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2019; 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.