Organization Active NPI

Farmington Clinic Company LLC

  • Surgery Physician
  • Farmington, MO
National Provider Identifier
1083667612
Registry record updated Sep 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
FARMINGTON CLINIC COMPANY LLC
Practice address
1212 Weber Rd
Farmington, MO 63640-3325
Phone
(573) 756-3662
Fax
(573) 756-3640
NPI assigned
May 17, 2006
Last updated
Sep 26, 2013By the provider in NPPES
Organization subpart
Yes
Parent organization
FARMINGTON CLINIC COMPANY LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 26, 2013

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

Authorized official

Name
Daniel S Slipkovich
Title
Ceo Capella Healthcare
Phone
(615) 764-3049

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X Primary

Addresses

Primary practice location

1212 Weber Rd
Farmington, MO 63640-3325

Mailing address

PO Box 9489
Belfast, ME 04915-9489
Phone (573) 756-3662

Other identifiers 1

IdentifierTypeStateIssuer
503111908MedicaidMO

National Provider Directory

National Provider Directory
Part of
Farmington Clinic Company L

NPI Registry JSON

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380153600000",
    "number": "1083667612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9489",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049159489",
            "telephone_number": "573-756-3662",
            "fax_number": "573-756-3640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1212 WEBER RD",
            "city": "FARMINGTON",
            "state": "MO",
            "postal_code": "636403325",
            "telephone_number": "573-756-3662",
            "fax_number": "573-756-3640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FARMINGTON CLINIC COMPANY LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FARMINGTON CLINIC COMPANY LLC",
        "enumeration_date": "2006-05-17",
        "last_updated": "2013-09-26",
        "status": "A",
        "authorized_official_last_name": "SLIPKOVICH",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "CEO CAPELLA HEALTHCARE",
        "authorized_official_telephone_number": "615-764-3049"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "503111908",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2013; 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.