M D M DO, LLC

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

M D M DO, LLC

Doing business as

Heritage Medical Clinic

Practice address

1011 Main St
Cassville, MO 65625-1335

Phone

(417) 846-2277

Fax

(417) 846-0176

NPI assigned

May 16, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Mark D Matthews, DONPI 1457348849

Title

Owner

Phone

(417) 846-2277

Specialties & licenses 1

Addresses

Other names 1

• HERITAGE MEDICAL CLINIC Doing business as

Locations

Practitioners 3

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.

• Mark D Matthews, D.O.

  • Family Medicine Physician
  • Cassville, MO
  • NPI 1457348849
  Authorized official Same address or phone
• Julie Frances Chrisco, FNP

  • Family Nurse Practitioner
  • Joplin, MO
  • NPI 1487682563
  NPD (past)
• Julie Ann Stapp, NP

  • Family Nurse Practitioner
  • Joplin, MO
  • NPI 1992784086
  NPD (past)

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1407808934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 MAIN ST",
            "city": "CASSVILLE",
            "state": "MO",
            "postal_code": "656251335",
            "telephone_number": "417-846-2277",
            "fax_number": "417-846-0176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 MAIN ST",
            "city": "CASSVILLE",
            "state": "MO",
            "postal_code": "656251335",
            "telephone_number": "417-846-2277",
            "fax_number": "417-846-0176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "M D M DO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MATTHEWS",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "417-846-2277",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HERITAGE MEDICAL CLINIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• John J. Jonikas, D.O.
• KMJ Enterprises Cassville LLC (Red Rose Health and Rehabilitation Center)
• Koinonia Kounseling, LLC
• Kristy Montz Chiropractor P C
• M & R Long, Inc (Cedar Ridge Care Center)
• Victor R Mangler, MD
• Mark D Matthews, D.O.
• Stephen Joseph Mebruer, O.D.
• Mercy Clinic Springfield Communities (Mercy Clinic Family Medicine-Cassville)
• Mercy Hospital Cassville (Mercy Clinic Cassville)

• Rural Health Clinic/Center in Cassville, MO
• Providers in Cassville, MO by specialty
• Rural Health Clinic/Center in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.