NPIMap

Organization Active NPI

Carthage Children's Clinic, LLC

  • Pediatric Adolescent Medicine Physician
  • Carthage, MO
National Provider Identifier
1073916623
Registry record updated Sep 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
License
R7F62 Issued in MO
Legal business name
CARTHAGE CHILDREN'S CLINIC, LLC
Practice address
1221 Oak St
Carthage, MO 64836-2028
Phone
(417) 359-9291
Fax
(417) 359-9241
NPI assigned
Sep 26, 2014
Last updated
Sep 26, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2014

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

Authorized official

Name
Denise M Hamar, D.O.NPI 1760412118
Title
Owner
Phone
(417) 359-9291

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
Pediatric Adolescent Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2080A0000X R7F62 MO Primary

Addresses

Primary practice location

1221 Oak St
Carthage, MO 64836-2028

Mailing address

1221 Oak St
Carthage, MO 64836-2028
Phone (417) 359-9291

National Provider Directory

National Provider Directory
Tax ID family
Carthage Children's Clinic LLC2 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.

Practitioners & affiliated clinicians

Practitioners 1

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": "1411689600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411689600000",
    "number": "1073916623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1221 OAK ST",
            "city": "CARTHAGE",
            "state": "MO",
            "postal_code": "648362028",
            "telephone_number": "417-359-9291",
            "fax_number": "417-359-9241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 OAK ST",
            "city": "CARTHAGE",
            "state": "MO",
            "postal_code": "648362028",
            "telephone_number": "417-359-9291",
            "fax_number": "417-359-9241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARTHAGE CHILDREN'S CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-26",
        "last_updated": "2014-09-26",
        "status": "A",
        "authorized_official_last_name": "HAMAR",
        "authorized_official_first_name": "DENISE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "417-359-9291",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "MO",
            "license": "R7F62",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carthage, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2014; 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.