Ziva Medical Audrain LLC

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

Legal business name

ZIVA MEDICAL AUDRAIN LLC

Doing business as

Zivamed Specialty Clinic

Practice address

515 E Promenade St # B
Mexico, MO 65265-2966

Phone

(573) 570-3510

Fax

(573) 675-6040

NPI assigned

Sep 22, 2023

Last updated

Dec 27, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Amanda Shurtz

Title

Ceo

Phone

(573) 570-3555

Specialties & licenses 6

Addresses

Other names 1

• ZIVAMED SPECIALTY CLINIC Doing business as

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

{
    "created_epoch": "1695340800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1703635200000",
    "number": "1225817042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 197",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087010197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 E PROMENADE ST # B",
            "city": "MEXICO",
            "state": "MO",
            "postal_code": "652652966",
            "telephone_number": "573-570-3510",
            "fax_number": "573-675-6040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ZIVA MEDICAL AUDRAIN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-22",
        "last_updated": "2023-12-27",
        "certification_date": "2023-12-27",
        "status": "A",
        "authorized_official_last_name": "SHURTZ",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "573-570-3555"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "163WP0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Pain Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ZIVAMED SPECIALTY CLINIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Carl L Willingham, HIS
• Eric Daniel Witt, R.PH.
• Aaron Witte
• Brandy Lynn Worley, FNP
• Ziva Medical Audrain LLC (Zivamed Surgery)
• Ziva Medical Audrain LLC (Zivamed Imaging)
• Ziva Medical Audrain LLC (Zivamed Primary Care)
• Ziva Medical Audrain LLC (Zivamed Lab)
• Ziva Medical Audrain LLC
• Ziva Medical Center LLC (Zivamed Laboratory)

• Orthopaedic Surgery Physician in Mexico, MO
• Providers in Mexico, MO by specialty
• Orthopaedic Surgery Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2023; 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.