Organization Active NPI

Midwest Cardiovascular Ultrasound Services, LLC

  • Contractor
  • Springfield, MO
National Provider Identifier
1508993379
Registry record updated Jun 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ContractorTaxonomy code 171W00000X
Legal business name
MIDWEST CARDIOVASCULAR ULTRASOUND SERVICES, LLC
Practice address
1700 S Campbell Ave Ste J
Springfield, MO 65807-2000
Phone
(417) 719-4026
Fax
(833) 792-4156
NPI assigned
Feb 27, 2007
Last updated
Jun 15, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2021

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

Authorized official

Name
Kevin ScottNPI 1093332421
Title
Owner
Phone
(417) 209-5700

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
ContractorGroup: 193400000X SINGLE SPECIALTY GROUP 171W00000X Primary
Physiological Laboratory 293D00000X

Addresses

Primary practice location

1700 S Campbell Ave Ste J
Springfield, MO 65807-2000

Mailing address

1700 S Campbell Ave Ste J
Springfield, MO 65807-2000
Phone (417) 209-5700

Other practice location 1

639A S Washington Ave
Lebanon, MO 65536-3618
Phone (417) 209-3785

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
26D1101102Midwest Cardiovascular Ultrasound, LLC1700 South Campbell, Ste J, Springfield, MO 65807Certificate of waiverJun 18, 2027

National Provider Directory

National Provider Directory

Locations

639 S Washington Ave
#A
Lebanon, MO 65536
Phone (417) 209-3785

1700 S Campbell Ave
Ste J
Springfield, MO 65807
Phone (417) 719-4026

Practitioners & affiliated clinicians

Practitioners 2

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": "1172534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623715200000",
    "number": "1508993379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 S CAMPBELL AVE STE J",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658072000",
            "telephone_number": "417-209-5700",
            "fax_number": "833-792-4156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 S CAMPBELL AVE STE J",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658072000",
            "telephone_number": "417-719-4026",
            "fax_number": "833-792-4156"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "639A S Washington Ave",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "MO",
            "postal_code": "655363618",
            "country_code": "US",
            "telephone_number": "417-209-3785",
            "fax_number": "833-792-4156",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MIDWEST CARDIOVASCULAR ULTRASOUND SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-27",
        "last_updated": "2021-06-15",
        "certification_date": "2020-08-25",
        "status": "A",
        "authorized_official_last_name": "SCOTT",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "417-209-5700"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Contractor",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.