NPIMap

Organization Active NPI

Boone Physician Services, LLC

  • Surgery Physician
  • Columbia, MO
National Provider Identifier
1295699486
Registry record updated Dec 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
BOONE PHYSICIAN SERVICES, LLC
Practice address
1605 E Broadway Ste 200
Columbia, MO 65201-8023
Phone
(573) 815-8000
NPI assigned
Dec 11, 2025
Last updated
Dec 11, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
BOONE PHYSICIAN SERVICES, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 11, 2025

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

Authorized official

Name
Edward James Clayton Jr.
Title
Chief Financial Officer
Phone
(573) 815-3072

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X Primary

Addresses

Primary practice location

1605 E Broadway Ste 200
Columbia, MO 65201-8023

Mailing address

1600 E Broadway
Columbia, MO 65201-5844
Phone (573) 815-8000

National Provider Directory

National Provider Directory
Tax ID family
Boone Physician Services LLC5 organizations share this tax ID, including this one
Part of
Boone Physician Services LLC

Other organizations with this tax ID 4

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

NPI Registry JSON

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

{
    "created_epoch": "1765411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765411200000",
    "number": "1295699486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 E BROADWAY",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652015844",
            "telephone_number": "573-815-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1605 E BROADWAY STE 200",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652018023",
            "telephone_number": "573-815-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOONE PHYSICIAN SERVICES, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BOONE PHYSICIAN SERVICES, LLC",
        "enumeration_date": "2025-12-11",
        "last_updated": "2025-12-11",
        "certification_date": "2025-12-11",
        "status": "A",
        "authorized_official_last_name": "CLAYTON",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "573-815-3072",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2025; 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.