NPIMap

Organization Active NPI

Poplar Bluff Neurology Center, PC

  • Medical Specialty Clinic/Center
  • Poplar Bluff, MO
National Provider Identifier
1154650331
Registry record updated Mar 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
License
104541 Issued in MO
Legal business name
POPLAR BLUFF NEUROLOGY CENTER, PC
Practice address
2210 Barron Rd
Suite 112
Poplar Bluff, MO 63901-1908
Phone
(573) 785-0889
Fax
(573) 785-2011
NPI assigned
Dec 16, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2015

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

Authorized official

Name
Dr. Shahid Karim Choudhary, M.D.
Title
Presedent
Phone
(573) 785-0889

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X 104541 MO Primary

Addresses

Primary practice location

2210 Barron Rd
Suite 112
Poplar Bluff, MO 63901-1908

Mailing address

2210 Barron Rd
Suite 112
Poplar Bluff, MO 63901-1908
Phone (573) 785-0889

National Provider Directory

National Provider Directory

Locations

2210 Barron Rd
Ste 112
Poplar Bluff, MO 63901
Phone (573) 785-0889

NPI Registry JSON

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

{
    "created_epoch": "1260921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1426032000000",
    "number": "1154650331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2210 BARRON RD",
            "address_2": "SUITE 112",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639011908",
            "telephone_number": "573-785-0889",
            "fax_number": "573-785-2011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2210 BARRON RD",
            "address_2": "SUITE 112",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639011908",
            "telephone_number": "573-785-0889",
            "fax_number": "573-785-2011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POPLAR BLUFF NEUROLOGY CENTER, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-16",
        "last_updated": "2015-03-11",
        "status": "A",
        "authorized_official_last_name": "CHOUDHARY",
        "authorized_official_first_name": "SHAHID",
        "authorized_official_middle_name": "KARIM",
        "authorized_official_title_or_position": "PRESEDENT",
        "authorized_official_telephone_number": "573-785-0889",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "MO",
            "license": "104541",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Poplar Bluff, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2015; 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.