NPIMap

Organization Active NPI

Saint Francis Medical Center

Doing business as Saint Francis Laboratory Dexter

  • Clinical Medical Laboratory
  • Dexter, MO
National Provider Identifier
1235916990
Registry record updated Sep 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
SAINT FRANCIS MEDICAL CENTER
Doing business as
Saint Francis Laboratory Dexter
Practice address
1212 Saint Francis Dr Ste 101
Dexter, MO 63841-2769
Phone
(573) 614-3611
Fax
(573) 614-3601
NPI assigned
Sep 14, 2023
Last updated
Sep 14, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2023

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

Authorized official

Name
Kim G Wittenborn, CPCS
Title
Director, MSS and Credentialing
Phone
(573) 331-3080

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

1212 Saint Francis Dr Ste 101
Dexter, MO 63841-2769

Mailing address

PO Box 801143
Kansas City, MO 64180-1143
Phone (573) 331-3000

Other names 1

  • Saint Francis Laboratory Dexter Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040107000140 MO Part B Supplier - Clinic/Group Practice 9931007929 Receives reassigned benefits from 615 practitioners
37 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
O20231101003300 MO Part B Supplier - Independent Clinical Laboratory 9931007929 Practice locations: Dexter, MO

Other NPIs with the same Medicare PAC ID 17

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 17

Other NPIs on the same Medicare enrollment 37

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 37

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
26D2091074Saint Francis Clinic Dexter1212 Saint Francis Drive, Dexter, MO 63841ComplianceJul 15, 2027

National Provider Directory

National Provider Directory
Tax ID family
St Francis Medical Cent24 organizations share this tax ID, including this one

Other organizations with this tax ID 23

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

View all 23

Ownership & related parties

All facility ownership & control disclosures 10

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Saint Francis Medical CenterCape Girardeau, MO, CCN 260183 Hospital Operational/Managerial Control Oct 2, 2007
St Francis Medical CenterCape Girardeau, MO, CCN 26T183 Hospital Operational/Managerial Control Oct 2, 2007
Saint Francis HospiceCape Girardeau, MO, CCN 261657 Hospice Operational/Managerial Control Jul 1, 2014
Saint Francis Clinic DexterDexter, MO, CCN 793839 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2015
Saint Francis Clinic Cape Girardeau KingshighwayCape Girardeau, MO, CCN 263897 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jul 1, 2014
Saint Francis Clinic Poplar BluffPoplar Bluff, MO, CCN 263968 Rural health clinic 5% Or Greater Direct Ownership Interest Jan 1, 2014
Saint Francis Clinic PiedmontPiedmont, MO, CCN 263933 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2015
Saint Francis Clinic JacksonJackson, MO, CCN 263914 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jan 2, 2014
Saint Francis Clinic CharlestonCharleston, MO, CCN 263830 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2019
Saint Francis Clinic FarmingtonFarmington, MO, CCN 793859 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jul 16, 2021

Owned or controlled facilities with NPI records 11

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1694649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694649600000",
    "number": "1235916990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 801143",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641801143",
            "telephone_number": "573-331-3000",
            "fax_number": "573-331-5073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1212 SAINT FRANCIS DR STE 101",
            "city": "DEXTER",
            "state": "MO",
            "postal_code": "638412769",
            "telephone_number": "573-614-3611",
            "fax_number": "573-614-3601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAINT FRANCIS MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-14",
        "last_updated": "2023-09-14",
        "certification_date": "2023-09-14",
        "status": "A",
        "authorized_official_last_name": "WITTENBORN",
        "authorized_official_first_name": "KIM",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "DIRECTOR, MSS AND CREDENTIALING",
        "authorized_official_telephone_number": "573-331-3080",
        "authorized_official_credential": "CPCS"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Saint Francis Laboratory Dexter",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dexter, MO

Sources for this page

Verify at the official NPI Registry.