Organization Active NPI

Physician Surgery Center

  • Multi-Specialty Clinic/Center
  • Rolla, MO
National Provider Identifier
1396991337
Registry record updated Aug 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
PHYSICIAN SURGERY CENTER
Practice address
1500 Hwy 72 East
Rolla, MO 65401-0000
Phone
(573) 426-6301
Fax
(573) 426-6304
NPI assigned
Aug 11, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2008

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

Authorized official

Name
Ann Deters
Title
President
Phone
(217) 342-2255

Specialties & licenses 1

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

Addresses

Primary practice location

1500 Hwy 72 East
Rolla, MO 65401-0000

Mailing address

1207 Network Centre Dr
P.O. Box 1294
Effingham, IL 62401-4632
Phone (217) 342-2255

National Provider Directory

National Provider Directory

Locations

1207 Network Centre Dr
Effingham, IL 62401

NPI Registry JSON

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

{
    "created_epoch": "1218412800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218412800000",
    "number": "1396991337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1207 NETWORK CENTRE DR",
            "address_2": "P.O. BOX 1294",
            "city": "EFFINGHAM",
            "state": "IL",
            "postal_code": "624014632",
            "telephone_number": "217-342-2255",
            "fax_number": "217-342-2619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 HWY 72 EAST",
            "city": "ROLLA",
            "state": "MO",
            "postal_code": "654010000",
            "telephone_number": "573-426-6301",
            "fax_number": "573-426-6304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIAN SURGERY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-11",
        "last_updated": "2008-08-11",
        "status": "A",
        "authorized_official_last_name": "DETERS",
        "authorized_official_first_name": "ANN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "217-342-2255"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rolla, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2008; 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.