Organization Active NPI

Samuel K. Turner D.O., P.C.

  • Medical Specialty Clinic/Center
  • Joplin, MO
National Provider Identifier
1447342720
Registry record updated Jan 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
License
R5J96 Issued in MO
Legal business name
SAMUEL K. TURNER D.O., P.C.
Practice address
702 E 34TH St
Suite 101
Joplin, MO 64804-3967
Phone
(417) 782-3032
Fax
(417) 782-6466
NPI assigned
Sep 28, 2006
Last updated
Jan 4, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2013

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

Authorized official

Name
Dr. Samuel K. Turner Jr., D.O.NPI 1356340368
Title
President of Company
Phone
(417) 782-3032

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
Medical Specialty Clinic/Center 261QM2500X R5J96 MO Primary

Addresses

Primary practice location

702 E 34TH St
Suite 101
Joplin, MO 64804-3967

Mailing address

702 E 34TH St
Suite 101
Joplin, MO 64804-3967
Phone (417) 782-3032

Other identifiers 2

IdentifierTypeStateIssuer
12848OtherBLUE SHIELD
242641702MedicaidMO

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110117000121 MO Part B Supplier - Clinic/Group Practice 7911196381 Receives reassigned benefits from 1 practitioner
Practice locations: Joplin, MO

National Provider Directory

National Provider Directory

Locations

702 E 34th St
Ste 101
Joplin, MO 64804
Phone (417) 782-3032

Practitioners & affiliated clinicians

Practitioners 1

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": "1159401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1357257600000",
    "number": "1447342720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 E 34TH ST",
            "address_2": "SUITE 101",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648043967",
            "telephone_number": "417-782-3032",
            "fax_number": "417-782-6466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 E 34TH ST",
            "address_2": "SUITE 101",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648043967",
            "telephone_number": "417-782-3032",
            "fax_number": "417-782-6466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMUEL K. TURNER D.O., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-28",
        "last_updated": "2013-01-04",
        "status": "A",
        "authorized_official_last_name": "TURNER",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "K.",
        "authorized_official_title_or_position": "PRESIDENT OF COMPANY",
        "authorized_official_telephone_number": "417-782-3032",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "MO",
            "license": "R5J96",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "12848",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "242641702",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Joplin, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.