NPIMap

Organization Active NPI

Excelsior Springs City Hospital

Doing business as Lawson Primary Care

  • Rural Health Clinic/Center
  • Lawson, MO
National Provider Identifier
1356916555
Registry record updated May 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
EXCELSIOR SPRINGS CITY HOSPITAL
Doing business as
Lawson Primary Care
Practice address
411 N Pennsylvania Ave
Lawson, MO 64062-9402
Phone
(816) 580-0055
Fax
(816) 580-0064
NPI assigned
May 21, 2021
Last updated
May 21, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 21, 2021

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

Authorized official

Name
Cameron Meyer
Title
Chief Financial Officer
Phone
(816) 629-2763

Specialties & licenses 1

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

Addresses

Primary practice location

411 N Pennsylvania Ave
Lawson, MO 64062-9402

Mailing address

PO Box 219756
Kansas City, MO 64121-9756
Phone (816) 630-6081

Other names 1

  • Lawson Primary Care Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210720003240 MO Part A Provider - Rural Health Clinic 7315847209 Practice locations: Lawson, MO

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1356916555. Details of each certification follow.

Rural health clinic certification: CCN 268792

Legal name
EXCELSIOR SPRINGS CITY HOSPITAL
Doing business as
LAWSON PRIMARY CARE
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Dec 28, 2022
Last certification
Dec 28, 2022
Ownership / control type
Non-profit – church related
Organization structure
GovernmentProprietary
Enrollment address
411 N Pennsylvania Ave
Lawson, MO 64062-9402
Related CCNs
261322

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 4

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

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
26D2056096Lawson Primary Care411 N Pennsylvania Ave, Lawson, MO 64062Certificate of waiverMar 21, 2028

National Provider Directory

National Provider Directory
Tax ID family
Excelsior Springs City Ho7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 3

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
City of Excelsior Springs Organization, Excelsior Springs, MO 5% Or Greater Direct Ownership Interest Jan 1, 1977 100%
Cameron G Meyer Individual Corporate Officer Feb 8, 2018
W-2 Managing Employee Feb 8, 2018
Operational/Managerial Control Feb 8, 2018
Kristen Dehart Individual Corporate Officer Jun 6, 2017
W-2 Managing Employee Jun 6, 2017
Operational/Managerial Control Jun 6, 2017

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

NPI Registry JSON

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

{
    "created_epoch": "1621555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621555200000",
    "number": "1356916555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 219756",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641219756",
            "telephone_number": "816-630-6081",
            "fax_number": "816-629-2707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 N PENNSYLVANIA AVE",
            "city": "LAWSON",
            "state": "MO",
            "postal_code": "640629402",
            "telephone_number": "816-580-0055",
            "fax_number": "816-580-0064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXCELSIOR SPRINGS CITY HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-21",
        "last_updated": "2021-05-21",
        "certification_date": "2021-05-18",
        "status": "A",
        "authorized_official_last_name": "MEYER",
        "authorized_official_first_name": "CAMERON",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "816-629-2763"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lawson Primary Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lawson, MO

Sources for this page

Verify at the official NPI Registry.