NPIMap

Organization Active NPI

Missouri Delta Medical Center

  • Internal Medicine Physician
  • Sikeston, MO
National Provider Identifier
1184709776
Registry record updated Mar 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
MISSOURI DELTA MEDICAL CENTER
Practice address
1008 N Main St
Sikeston, MO 63801-5044
Phone
(573) 471-1600
Fax
(573) 472-7740
NPI assigned
Oct 25, 2006
Last updated
Mar 3, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2015

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

Authorized official

Name
Jason Schrumpf
Title
Ceo/President
Phone
(573) 472-7601

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU Primary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X NU
Hematology & Oncology Physician 207RH0003X NU

Addresses

Primary practice location

1008 N Main St
Sikeston, MO 63801-5044

Mailing address

1008 N Main St
Sikeston, MO 63801-5044
Phone (573) 471-1600

Other identifiers 1

IdentifierTypeStateIssuer
505957001MedicaidMO

National Provider Directory

National Provider Directory
Tax ID family
D Link Crna26 organizations share this tax ID, including this one

Other organizations with this tax ID 25

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

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1425340800000",
    "number": "1184709776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1008 N MAIN ST",
            "city": "SIKESTON",
            "state": "MO",
            "postal_code": "638015044",
            "telephone_number": "573-471-1600",
            "fax_number": "573-472-7740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1008 N MAIN ST",
            "city": "SIKESTON",
            "state": "MO",
            "postal_code": "638015044",
            "telephone_number": "573-471-1600",
            "fax_number": "573-472-7740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSOURI DELTA MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-25",
        "last_updated": "2015-03-03",
        "status": "A",
        "authorized_official_last_name": "SCHRUMPF",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "573-472-7601"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "505957001",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sikeston, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 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.