Organization Active NPI

Myers Clinic LLC

  • Family Medicine Physician
  • Rolla, MO
National Provider Identifier
1417800012
Registry record updated May 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MYERS CLINIC LLC
Practice address
604 W 6TH St Ste a
Rolla, MO 65401-2968
Phone
(573) 364-9352
Fax
(844) 689-7577
NPI assigned
Feb 16, 2026
Last updated
May 21, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 21, 2026

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

Authorized official

Name
Mylhan Myers, DONPI 1639699747
Title
Owner and Physician
Phone
(573) 364-9352

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

604 W 6TH St Ste a
Rolla, MO 65401-2968

Mailing address

604 W 6TH St Ste a
Rolla, MO 65401-2968
Phone (573) 364-9352

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260421001236 MO Part B Supplier - Clinic/Group Practice 1153897731 Receives reassigned benefits from 2 practitioners
Practice locations: Rolla, MO

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
26D2343749Myers Clinic LLC604 W 6TH Street Suite a, Rolla, MO 65401Certificate of waiverMay 11, 2028

National Provider Directory

National Provider Directory

Locations

604 W 6th St
Ste A
Rolla, MO 65401
Phone (573) 341-8500

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1771200000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1779321600000",
    "number": "1417800012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "604 W 6TH ST STE A",
            "city": "ROLLA",
            "state": "MO",
            "postal_code": "654012968",
            "telephone_number": "573-364-9352",
            "fax_number": "844-689-7577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "604 W 6TH ST STE A",
            "city": "ROLLA",
            "state": "MO",
            "postal_code": "654012968",
            "telephone_number": "573-364-9352",
            "fax_number": "844-689-7577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MYERS CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-02-16",
        "last_updated": "2026-05-21",
        "certification_date": "2026-05-21",
        "status": "A",
        "authorized_official_last_name": "MYERS",
        "authorized_official_first_name": "MYLHAN",
        "authorized_official_title_or_position": "OWNER AND PHYSICIAN",
        "authorized_official_telephone_number": "573-364-9352",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "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 May 21, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.