NPIMap

Organization Active NPI

SSM Regional Health Services

Doing business as St. Marys Eldon Medical Clinic

  • Clinic/Center
  • Eldon, MO
National Provider Identifier
1528014156
Registry record updated Jul 28, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
SSM REGIONAL HEALTH SERVICES
Doing business as
St. Marys Eldon Medical Clinic
Practice address
1112 E North St
Eldon, MO 65026-2602
Phone
(573) 392-3767
Fax
(573) 392-1976
NPI assigned
May 25, 2006
Last updated
Jul 28, 2007By the provider in NPPES
Organization subpart
Yes
Parent organization
SSM REGIONAL HEALTH SERVICESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 28, 2007

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

Authorized official

Name
Brent Van Conia
Title
President
Phone
(573) 761-7000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X NU Primary

Addresses

Primary practice location

1112 E North St
Eldon, MO 65026-2602

Mailing address

PO Box 1027
Jefferson City, MO 65102-1027
Phone (573) 761-7246

Other names 1

  • St. Marys Eldon Medical Clinic Doing business as

National Provider Directory

National Provider Directory
Part of
St Marys Health Center

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

1112 E North St
Eldon, MO 65026
Phone (573) 392-3767

Practitioners & affiliated clinicians

Practitioners 18

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.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185580800000",
    "number": "1528014156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1027",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651021027",
            "telephone_number": "573-761-7246",
            "fax_number": "573-761-6947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1112 E NORTH ST",
            "city": "ELDON",
            "state": "MO",
            "postal_code": "650262602",
            "telephone_number": "573-392-3767",
            "fax_number": "573-392-1976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SSM REGIONAL HEALTH SERVICES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SSM REGIONAL HEALTH SERVICES",
        "enumeration_date": "2006-05-25",
        "last_updated": "2007-07-28",
        "status": "A",
        "authorized_official_last_name": "VAN CONIA",
        "authorized_official_first_name": "BRENT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "573-761-7000"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St. Marys Eldon Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Eldon, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2007; 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.