NPIMap

Organization Active NPI

Moberly Medical Clinics Inc

  • Multi-Specialty Clinic/Center
  • Moberly, MO
National Provider Identifier
1336135607
Registry record updated Sep 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
MOBERLY MEDICAL CLINICS INC
Practice address
1515 Union Ave
Moberly, MO 65270-9407
Phone
(660) 263-8400
NPI assigned
Sep 22, 2005
Last updated
Sep 28, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2026

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

Authorized official

Name
Debbie Brewer
Title
Director of Provider Enrollment
Phone
(615) 465-7626

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X NU Primary

Addresses

Primary practice location

1515 Union Ave
Moberly, MO 65270-9407

Mailing address

1515 Union Ave
Moberly, MO 65270-9407
Phone (660) 269-3191

Other identifiers 1

IdentifierTypeStateIssuer
508262003MedicaidMO

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040610000009 MO Part B Supplier - Clinic/Group Practice 8426031592 Receives reassigned benefits from 14 practitioners
Practice locations: Columbia, MO; Kirksville, MO; Moberly, MO; Poplar Bluff, MO

Other NPIs with the same Medicare PAC ID 1

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

National Provider Directory

National Provider Directory

Locations

109 East St
Clarence, MO 63437
Phone (660) 699-2124

1501 Union Ave
Ste Cd
Moberly, MO 65270
Phone (660) 263-4770

1513 Union Ave
Ste 1500
Moberly, MO 65270
Phone (660) 263-0524

1513 Union Ave
Ste 2200
Moberly, MO 65270
Phone (660) 263-1517

1517 Union Ave
Ste A
Moberly, MO 65270
Phone (660) 263-7201

Practitioners & affiliated clinicians

Practitioners 39

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.

View all 39

NPI Registry JSON

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

{
    "created_epoch": "1127347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1790553600000",
    "number": "1336135607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 UNION AVE",
            "city": "MOBERLY",
            "state": "MO",
            "postal_code": "652709407",
            "telephone_number": "660-269-3191",
            "fax_number": "660-269-2943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 UNION AVE",
            "city": "MOBERLY",
            "state": "MO",
            "postal_code": "652709407",
            "telephone_number": "660-263-8400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOBERLY MEDICAL CLINICS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-22",
        "last_updated": "2026-09-28",
        "certification_date": "2026-09-28",
        "status": "A",
        "authorized_official_last_name": "BREWER",
        "authorized_official_first_name": "DEBBIE",
        "authorized_official_title_or_position": "DIRECTOR OF PROVIDER ENROLLMENT",
        "authorized_official_telephone_number": "615-465-7626"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "508262003",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Moberly, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2026; 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.