Mercy Clinic-Springfield Communities

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

102991 Issued in MO

Legal business name

MERCY CLINIC-SPRINGFIELD COMMUNITIES

Doing business as

Mercy Clinic-Smith Glynn Callaway

Practice address

3231 S National Ave
Springfield, MO 65807-7304

Phone

(417) 883-7422

NPI assigned

Jan 3, 2007

Last updated

Feb 7, 2012By 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

Donn Sorensen

Title

Chief Operating Officer

Phone

(417) 829-4264

Specialties & licenses 9

Addresses

Other names 1

• MERCY CLINIC-SMITH GLYNN CALLAWAY Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1328572800000",
    "number": "1407913676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2580",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658012580",
            "telephone_number": "417-829-4620",
            "fax_number": "417-829-4316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3231 S NATIONAL AVE",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658077304",
            "telephone_number": "417-883-7422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY CLINIC-SPRINGFIELD COMMUNITIES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-03",
        "last_updated": "2012-02-07",
        "status": "A",
        "authorized_official_last_name": "SORENSEN",
        "authorized_official_first_name": "DONN",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "417-829-4264"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MO",
            "license": "102991",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "T002235",
            "primary": false
        },
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "MO",
            "license": "105723",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MO",
            "license": "R8F16",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "R3B79",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "MO",
            "license": "R9348",
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "MO",
            "license": "R8331",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MO",
            "license": "108358",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "R5004",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MERCY CLINIC-SMITH GLYNN CALLAWAY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Mercy Hospital Springfield
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• Durable Medical Equipment & Medical Supplies in Springfield, MO
• Providers in Springfield, MO by specialty
• Durable Medical Equipment & Medical Supplies in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.