Organization Active NPI

Cavero Medical Group LLC

  • Internal Medicine Physician
  • Springfield, MO
National Provider Identifier
1528294634
Registry record updated May 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
101935 Issued in MO
Legal business name
CAVERO MEDICAL GROUP LLC
Practice address
1514 W Lark St
Springfield, MO 65810-2262
Phone
(417) 631-2303
Fax
(417) 890-4677
NPI assigned
Jun 3, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 22, 2015

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

Authorized official

Name
Dr. Fernando Cavero, MD
Title
Officer
Phone
(417) 631-2303

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 101935 MO Primary

Addresses

Primary practice location

1514 W Lark St
Springfield, MO 65810-2262

Mailing address

1514 W Lark St
Springfield, MO 65810-2262
Phone (417) 631-2303

Other identifiers 2

IdentifierTypeStateIssuer
203445101MedicaidMO
101935OtherMOMEDICAL LICENSE

National Provider Directory

National Provider Directory

Locations

1950 E Republic Rd
Springfield, MO 65804
Phone (417) 413-1115

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1243987200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1432252800000",
    "number": "1528294634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1514 W LARK ST",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658102262",
            "telephone_number": "417-631-2303",
            "fax_number": "417-890-4677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1514 W LARK ST",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658102262",
            "telephone_number": "417-631-2303",
            "fax_number": "417-890-4677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAVERO MEDICAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-03",
        "last_updated": "2015-05-22",
        "status": "A",
        "authorized_official_last_name": "CAVERO",
        "authorized_official_first_name": "FERNANDO",
        "authorized_official_title_or_position": "OFFICER",
        "authorized_official_telephone_number": "417-631-2303",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "101935",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "203445101",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "101935",
            "state": "MO"
        }
    ],
    "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 May 22, 2015; 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.