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Mercy Clinic-Springfield Communities

Organization Active NPI Rural Health Clinic/Center · Shell Knob, MO

NPI 1104137876 · NPPES record last updated Apr 28, 2015

Key facts

NPI
1104137876
Entity type
Organization (NPI type 2)
Primary specialty
Rural Health Clinic/Center 261QR1300X
Legal business name
MERCY CLINIC-SPRINGFIELD COMMUNITIES
Practice address
22361 Oak Ridge Dr
Shell Knob, MO 65747-7822
Phone
(417) 858-3731
Fax
(417) 858-2562
NPI assigned
Jun 28, 2010
Organization subpart
No

Authorized official

Name
Stuart G. Stangeland
Title
Senior Vice President, Coo
Phone
(417) 820-6556

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
26D0701240Mercy Clinic Family Medicine Shell Knob
22361 Oak Ridge Drive, Shell Knob, MO 65747		Certificate of waiverMay 3, 2027

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X MO Yes

Addresses

Primary practice location

22361 Oak Ridge Dr
Shell Knob, MO 65747-7822

Mailing address

PO Box 505164
Saint Louis, MO 63150-5164
Phone (417) 820-2000

Other identifiers

IdentifierTypeStateIssuer
1104137876OtherMORURAL HEALTH MEDICAID

Other names

  • Mercy Clinic Family Medicine-Shell Knob Doing business as

Other providers in Shell Knob, MO

All providers in Shell Knob, MO · Rural Health Clinic/Center in Missouri

Sources for this page

Verify at the official NPI Registry.