NPIMap

Organization Active NPI

Healthmont of Missouri LLC

  • Rural Health Clinic/Center
  • Fulton, MO
National Provider Identifier
1295778314
Registry record updated Feb 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
HEALTHMONT OF MISSOURI LLC
Doing business as
Fulton Medical Clinic
Practice address
850 W Hospital Dr
Suite F
Fulton, MO 65251
Phone
(573) 642-5338
Fax
(573) 642-9224
NPI assigned
Jun 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2012

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

Authorized official

Name
John Graves
Title
Ceo
Phone
(573) 642-3376

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

850 W Hospital Dr
Suite F
Fulton, MO 65251

Mailing address

850 W Hospital Dr
Suite F
Fulton, MO 65251
Phone (573) 642-5338

Other names 1

  • Fulton Medical Clinic Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329177600000",
    "number": "1295778314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 W HOSPITAL DR",
            "address_2": "SUITE F",
            "city": "FULTON",
            "state": "MO",
            "postal_code": "65251",
            "telephone_number": "573-642-5338",
            "fax_number": "573-642-9224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 W HOSPITAL DR",
            "address_2": "SUITE F",
            "city": "FULTON",
            "state": "MO",
            "postal_code": "65251",
            "telephone_number": "573-642-5338",
            "fax_number": "573-642-9224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHMONT OF MISSOURI LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-14",
        "last_updated": "2012-02-14",
        "status": "A",
        "authorized_official_last_name": "GRAVES",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "573-642-3376"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fulton Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fulton, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2012; 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.