NPIMap

Individual provider Active NPI

Laura C Vance, M.D.

  • Family Medicine Physician
  • Bolivar, MO
National Provider Identifier
1225050784
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
108394 Issued in MO
Practice address
1240 N Butterfield Rd
Bolivar, MO 65613-3016
Phone
(417) 326-6021
Fax
(417) 326-6347
NPI assigned
Jul 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 108394 MO Primary

Addresses

Primary practice location

1240 N Butterfield Rd
Bolivar, MO 65613-3016

Mailing address

1240 N Butterfield Rd
Bolivar, MO 65613-3016
Phone (417) 326-6021

Other identifiers 1

IdentifierTypeStateIssuer
115020OtherMOBCBS OF MO #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120120000100 MO Practitioner - Family Practice 2961679626 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Missouri, Kansas City, School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Citizens Memorial Healthcare 144 clinicians

Practice addresses (Care Compare)

Bolivar, MO 65613
Phone (417) 328-6631

1125 N Butterfield Rd
CMH Dermatology
Bolivar, MO 65613-1056
Phone (417) 328-4500

1155 W Parkview
Bolivar, MO 65613-7800

1155 W Parkview
2K CMH Rheumatology
Bolivar, MO 65613-8598
Phone (417) 328-7000

1155 W Parkview St
Bolivar, MO 65613-7800

1155 W Parkview St
Bolivar, MO 65613-8597

1155 W Parkview St
1C
Bolivar, MO 65613-8279
Phone (417) 326-7246

1155 W Parkview St
Suite 2J
Bolivar, MO 65613-8598
Phone (417) 328-7702

1160 W Parkview St
CMH Nephrology Clinic
Bolivar, MO 65613-8279
Phone (417) 328-7300

1245 N Butterfield Rd
Bolivar, MO 65613-3017

1500 N Oakland Ave
CMH Diabetes
Bolivar, MO 65613-3099
Phone (417) 328-6040

1501 N Oakland Ave
CMH Oncology Clinic
Bolivar, MO 65613-3020
Phone (417) 328-7200

2001 W Broadway St
Bolivar, MO 65613-1861

Hospital & facility affiliations

  • Citizens Memorial Home Health Home health agency, Bolivar, MO, CCN 267196
  • Citizens Memorial Hospice Hospice, Bolivar, MO, CCN 261508
  • Citizens Memorial Hospital Hospital, Bolivar, MO, CCN 260195
  • Cox Medical Centers Hospital, Springfield, MO, CCN 260040
  • Mercy Hospital Springfield Hospital, Springfield, MO, CCN 260065

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
108394MOMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Citizens Memorial Healthcare CurrentSince Oct 1, 2013 Accepting new patients
Citizens Memorial Healthcare Family Medicine CurrentSince Oct 1, 2013 Accepting new patients
Bolivar Family Care Center, LLC Family Medicine Current Accepting new patients
Ozarks Medical Center Family Medicine Past Accepting new patients

Locations

1240 N Butterfield Rd
Bolivar, MO 65613
Phone (417) 326-6021

1500 N Oakland Ave
Bolivar, MO 65613
Phone (417) 326-6000

Organizations & group practices 16

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

View all 16

Hospital & facility affiliations 15

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1225050784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1240 N BUTTERFIELD RD",
            "city": "BOLIVAR",
            "state": "MO",
            "postal_code": "656133016",
            "telephone_number": "417-326-6021",
            "fax_number": "417-326-6347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1240 N BUTTERFIELD RD",
            "city": "BOLIVAR",
            "state": "MO",
            "postal_code": "656133016",
            "telephone_number": "417-326-6021",
            "fax_number": "417-326-6347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANCE",
        "first_name": "LAURA",
        "middle_name": "C",
        "name_prefix": "Mrs.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-24",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "108394",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MO #",
            "identifier": "115020",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bolivar, MO

Sources for this page

Verify at the official NPI Registry.