NPIMap

Organization Active NPI

Central Care PA

Doing business as Central Care Cancer Center

  • Non-Pharmacy Dispensing Site
  • Bolivar, MO
National Provider Identifier
1316372154
Registry record updated Apr 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
License
002905 Issued in MO
Legal business name
CENTRAL CARE PA
Doing business as
Central Care Cancer Center
Practice address
1501 N Oakland Ave
Bolivar, MO 65613-3020
Phone
(417) 326-7200
Fax
(417) 326-7201
NPI assigned
Sep 12, 2013
Last updated
Apr 2, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2024

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

Authorized official

Name
Candice Evans
Title
Credentialing
Phone
(620) 603-8846

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Oncology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RX0202X
Radiation Oncology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0001X
Non-Pharmacy Dispensing Site 332900000X 002905 MO Primary

Addresses

Primary practice location

1501 N Oakland Ave
Bolivar, MO 65613-3020

Mailing address

PO Box 256
Salina, KS 67402-0256
Phone (785) 823-0633

Other names 1

  • CENTRAL CARE CANCER CENTER Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140324001978 MO DME Supplier - Physician - General Surgery 7911801014 Practice locations: Bolivar, MO

Other NPIs with the same Medicare PAC ID 2

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

National Provider Directory

National Provider Directory
Tax ID family
Central Care Cancer Ctr20 organizations share this tax ID, including this one

Other organizations with this tax ID 19

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

View all 19

Locations

1501 N Oakland Ave
Bolivar, MO 65613
Phone (417) 326-7200

NPI Registry JSON

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

{
    "created_epoch": "1378944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712016000000",
    "number": "1316372154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 256",
            "city": "SALINA",
            "state": "KS",
            "postal_code": "674020256",
            "telephone_number": "785-823-0633",
            "fax_number": "785-823-0658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 N OAKLAND AVE",
            "city": "BOLIVAR",
            "state": "MO",
            "postal_code": "656133020",
            "telephone_number": "417-326-7200",
            "fax_number": "417-326-7201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL CARE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-12",
        "last_updated": "2024-04-02",
        "certification_date": "2024-04-02",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "CANDICE",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "620-603-8846"
    },
    "taxonomies": [
        {
            "code": "207RX0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Medical Oncology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Radiation Oncology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "MO",
            "license": "002905",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CENTRAL CARE CANCER CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bolivar, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.