NPIMap

Organization Active NPI

Saint Francis Medical Center

Doing business as Physicians Park General Surgery

  • Surgery Physician
  • Poplar Bluff, MO
National Provider Identifier
1386118917
Registry record updated Jan 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
SAINT FRANCIS MEDICAL CENTER
Doing business as
Physicians Park General Surgery
Practice address
225 Physicians Park Ste 301
Poplar Bluff, MO 63901-3930
Phone
(573) 686-2220
Fax
(573) 686-5642
NPI assigned
Jan 16, 2019
Last updated
Jan 16, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
SAINT FRANCIS MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 16, 2019

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

Authorized official

Name
Kim G Wittenborn, CPCS
Title
Manager
Phone
(573) 331-3080

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X Primary

Addresses

Primary practice location

225 Physicians Park Ste 301
Poplar Bluff, MO 63901-3930

Mailing address

225 Physicians Park Ste 301
Poplar Bluff, MO 63901-3930
Phone (573) 686-2220

Other names 1

  • Physicians Park General Surgery Doing business as

National Provider Directory

National Provider Directory
Tax ID family
St Francis Medical Cent27 organizations share this tax ID, including this one
Part of
St Francis Medical Cent

Other organizations with this tax ID 26

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

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1547596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1547596800000",
    "number": "1386118917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 PHYSICIANS PARK STE 301",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639013930",
            "telephone_number": "573-686-2220",
            "fax_number": "573-686-5642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 PHYSICIANS PARK STE 301",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639013930",
            "telephone_number": "573-686-2220",
            "fax_number": "573-686-5642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAINT FRANCIS MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SAINT FRANCIS MEDICAL CENTER",
        "enumeration_date": "2019-01-16",
        "last_updated": "2019-01-16",
        "status": "A",
        "authorized_official_last_name": "WITTENBORN",
        "authorized_official_first_name": "KIM",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "573-331-3080",
        "authorized_official_credential": "CPCS"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Physicians Park General Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Poplar Bluff, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2019; 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.