NPIMap

Organization Active NPI

Noble Health Audrain Inc

Doing business as Audrain Comm Specialty Clinic

  • Orthopaedic Surgery Physician
  • Mexico, MO
National Provider Identifier
1437733185
Registry record updated Jun 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
NOBLE HEALTH AUDRAIN INC
Doing business as
Audrain Comm Specialty Clinic
Practice address
515 E Promenade St
Mexico, MO 65265-2966
Phone
(573) 582-8979
Fax
(573) 582-3220
NPI assigned
May 10, 2021
Last updated
Jun 23, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
NOBLE HEALTH AUDRAIN INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 23, 2022

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

Authorized official

Name
Amy L Obrien
Title
Ceo
Phone
(573) 582-5000

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) Physician 207LP2900X NU
Orthopaedic Surgery Physician 207X00000X NU Primary
Interventional Pain Medicine Physician 208VP0014X NU

Addresses

Primary practice location

515 E Promenade St
Mexico, MO 65265-2966

Mailing address

515 E Promenade St
Mexico, MO 65265-2966
Phone (573) 582-8979

Other names 1

  • Audrain Comm Specialty Clinic Doing business as

National Provider Directory

National Provider Directory
Part of
Audrain Comm Cancer Center

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1620604800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655942400000",
    "number": "1437733185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 E PROMENADE ST",
            "city": "MEXICO",
            "state": "MO",
            "postal_code": "652652966",
            "telephone_number": "573-582-8979",
            "fax_number": "573-582-3220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 E PROMENADE ST",
            "city": "MEXICO",
            "state": "MO",
            "postal_code": "652652966",
            "telephone_number": "573-582-8979",
            "fax_number": "573-582-3220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOBLE HEALTH AUDRAIN INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NOBLE HEALTH AUDRAIN INC",
        "enumeration_date": "2021-05-10",
        "last_updated": "2022-06-23",
        "certification_date": "2022-06-23",
        "status": "A",
        "authorized_official_last_name": "OBRIEN",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "573-582-5000"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Audrain Comm Specialty Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mexico, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2022; 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.