Pcrmc Medical Group, Inc

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

Legal business name

PCRMC MEDICAL GROUP, INC

Practice address

1050 W 10TH St
Rolla, MO 65401-2905

Phone

(573) 458-3431

Fax

(573) 458-3433

NPI assigned

Jul 26, 2007

Last updated

May 1, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

John Denbo

Title

Ceo

Phone

(573) 458-8899

Specialties & licenses 2

Addresses

Other names 1

• PCRMC Medical Group Rieth Other name

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Pcrmc Medical Group, Inc

  dba Phelps Health Medical Group Rolla

  • Clinic/Center
  • Rolla, MO
  • NPI 1124237227

  O20070829000437

  Same enrollment

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

{
    "created_epoch": "1185408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682899200000",
    "number": "1508056540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 579",
            "city": "ROLLA",
            "state": "MO",
            "postal_code": "654020579",
            "telephone_number": "314-989-0300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 W 10TH ST",
            "city": "ROLLA",
            "state": "MO",
            "postal_code": "654012905",
            "telephone_number": "573-458-3431",
            "fax_number": "573-458-3433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PCRMC MEDICAL GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-26",
        "last_updated": "2023-05-01",
        "certification_date": "2023-05-01",
        "status": "A",
        "authorized_official_last_name": "DENBO",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "573-458-8899"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PCRMC Medical Group Rieth",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "PCRMC Medical Group Rieth",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Yogesh R Patel, MD
• Pathways Community Behavioral Healthcare, Inc
• Pcrmc - Bond Clinic Medical Group (Bond Clinic)
• Pcrmc Medical Group Inc
• Pcrmc Medical Group, Inc (Phelps Health Medical Group Rolla)
• Pcrmc-Health Services, Inc. (Phelps Health Homecare)
• Pcrmc-Health Services, Inc. (Phelps Health Homecare)
• Pcrmc-Health Services, Inc. (Phelps Health Home Health & Hospice)
• Pcrmc-Health Services, Inc. (Phelps Health Home Health & Hospice)
• Peaceful Heart Counseling LLC

• Physical Medicine & Rehabilitation Physician in Rolla, MO
• Providers in Rolla, MO by specialty
• Physical Medicine & Rehabilitation Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2023; 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.