Hannibal Clinic Operations, L.L.C.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

HANNIBAL CLINIC OPERATIONS, L.L.C.

Practice address

400 N Main St
Monroe City, MO 63456-1318

Phone

(573) 735-4541

Fax

(573) 735-2143

NPI assigned

Jan 11, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Michael J Bukstein, MD

Title

Physician Exec Director

Phone

(573) 231-3172

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Hannibal Clinic @ Monroe City Other name

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1136937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650240000000",
    "number": "1447239157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MEDICAL DR",
            "city": "HANNIBAL",
            "state": "MO",
            "postal_code": "634016877",
            "telephone_number": "573-221-5250",
            "fax_number": "573-231-3824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 N MAIN ST",
            "city": "MONROE CITY",
            "state": "MO",
            "postal_code": "634561318",
            "telephone_number": "573-735-4541",
            "fax_number": "573-735-2143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HANNIBAL CLINIC OPERATIONS, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-11",
        "last_updated": "2022-04-18",
        "certification_date": "2022-04-18",
        "status": "A",
        "authorized_official_last_name": "BUKSTEIN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PHYSICIAN EXEC DIRECTOR",
        "authorized_official_telephone_number": "573-231-3172",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "000013771",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "affiliationName": "Cobrius Healthcare Solutions",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Hannibal Clinic @ Monroe City",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Hannibal Clinic @ Monroe City",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Enochs Care Center
• Gateway Pharmacy
• Gateway Pharmacy of Monroe City
• Gosney Pharmacy Inc
• Karen J Grawe, FNP-BC
• Hannibal Clinic Operations, L.L.C.
• Hannibal Regional Healthcare System, Inc
• Dean Richard Hull, DDS
• Ashley Marie Lanpher, RN BSN APRN FNP-C
• Learning Opportunities, Quality Works, Inc.

• Internal Medicine Physician in Monroe City, MO
• Providers in Monroe City, MO by specialty
• Internal Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 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.