Edment, LLC

Primary specialty

Otolaryngology/Facial Plastic Surgery PhysicianTaxonomy code 207YX0905X

License

2003013945 Issued in MO

Legal business name

EDMENT, LLC

Practice address

5780 Highway 54
Suite 113
Osage Beach, MO 65065-3043

Phone

(573) 348-2775

Fax

(573) 348-1284

NPI assigned

Aug 7, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Erich Daniel Mertensmeyer, D.O.

Title

Owner

Phone

(573) 348-2775

Specialties & licenses 1

Addresses

Other names 1

• Lake Ozark Ear, Nose & Throat Doing business as

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

{
    "created_epoch": "1186444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1274400000000",
    "number": "1407047178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5780 HIGHWAY 54",
            "address_2": "SUITE 113",
            "city": "OSAGE BEACH",
            "state": "MO",
            "postal_code": "650653043",
            "telephone_number": "573-348-2775",
            "fax_number": "573-348-1284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5780 HIGHWAY 54",
            "address_2": "SUITE 113",
            "city": "OSAGE BEACH",
            "state": "MO",
            "postal_code": "650653043",
            "telephone_number": "573-348-2775",
            "fax_number": "573-348-1284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDMENT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-07",
        "last_updated": "2010-05-21",
        "status": "A",
        "authorized_official_last_name": "MERTENSMEYER",
        "authorized_official_first_name": "ERICH",
        "authorized_official_middle_name": "DANIEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "573-348-2775",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207YX0905X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "MO",
            "license": "2003013945",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lake Ozark Ear, Nose & Throat",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• William Michael Duff, MD
• Kelsey Dulin
• Hailey Dunn, FNP
• John B Dymond, M.D.
• Kristen Marie Eblen, PHARMD
• Brad Einerson
• James E Eisenhardt, DC
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• Elite Health Concepts, LLC
• Elite Mental Health & Wellness, LLC

• All providers in Osage Beach, MO
• Otolaryngology/Facial Plastic Surgery Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2010; 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.