NPIMap

Organization Active NPI

Dexter Hosptial LLC

Doing business as Dexter Internal Medicine

  • Internal Medicine Physician
  • Dexter, MO
National Provider Identifier
1477613370
Registry record updated Apr 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
DEXTER HOSPTIAL LLC
Doing business as
Dexter Internal Medicine
Practice address
1300 N One Mile Rd
Suite 1
Dexter, MO 63841
Phone
(573) 624-7788
NPI assigned
Dec 11, 2006
Last updated
Apr 9, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2008

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

Authorized official

Name
Sue Ann Williams
Title
Clinic Administrator
Phone
(573) 624-1640

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X Primary

Addresses

Primary practice location

1300 N One Mile Rd
Suite 1
Dexter, MO 63841

Mailing address

PO Box 368
Dexter, MO 63841
Phone (573) 624-3165

Other identifiers 1

IdentifierTypeStateIssuer
DC5219OtherMORAILROAD MEDICARE

Other names 1

  • DEXTER INTERNAL MEDICINE Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Dexter Hospital LLC6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207699200000",
    "number": "1477613370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 368",
            "city": "DEXTER",
            "state": "MO",
            "postal_code": "63841",
            "telephone_number": "573-624-3165",
            "fax_number": "573-624-3157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 N ONE MILE RD",
            "address_2": "SUITE 1",
            "city": "DEXTER",
            "state": "MO",
            "postal_code": "63841",
            "telephone_number": "573-624-7788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEXTER HOSPTIAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-11",
        "last_updated": "2008-04-09",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "SUE ANN",
        "authorized_official_title_or_position": "CLINIC ADMINISTRATOR",
        "authorized_official_telephone_number": "573-624-1640"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DC5219",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DEXTER INTERNAL MEDICINE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dexter, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2008; 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.