NPIMap

Organization Active NPI

Dexter Hospital LLC

Doing business as Dexter Childrens Clinic

  • Pediatrics Physician
  • Dexter, MO
National Provider Identifier
1073656153
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
DEXTER HOSPITAL LLC
Doing business as
Dexter Childrens Clinic
Practice address
1300 N One Mile Rd
Suite 2
Dexter, MO 63841-1042
Phone
(573) 624-6442
NPI assigned
Feb 15, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Sue Williams
Title
Clinic Administrator
Phone
(573) 624-1640

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MO Primary

Addresses

Primary practice location

1300 N One Mile Rd
Suite 2
Dexter, MO 63841-1042

Mailing address

PO Box 368
Dexter, MO 63841-0368
Phone (573) 624-3165

Other names 1

  • DEXTER CHILDRENS CLINIC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Dexter Hospital LLC6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

NPI Registry JSON

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1073656153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 368",
            "city": "DEXTER",
            "state": "MO",
            "postal_code": "638410368",
            "telephone_number": "573-624-3165",
            "fax_number": "573-624-3157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 N ONE MILE RD",
            "address_2": "SUITE 2",
            "city": "DEXTER",
            "state": "MO",
            "postal_code": "638411042",
            "telephone_number": "573-624-6442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEXTER HOSPITAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "SUE",
        "authorized_official_title_or_position": "CLINIC ADMINISTRATOR",
        "authorized_official_telephone_number": "573-624-1640"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DEXTER CHILDRENS CLINIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dexter, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.