NPIMap

Organization Active NPI

BRHC

  • Cardiovascular Disease Physician
  • Sedalia, MO
National Provider Identifier
1528348786
Registry record updated Dec 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
BRHC
Practice address
3700 W 10TH Street
Suite 200
Sedalia, MO 65301-2540
Phone
(660) 827-1771
Fax
(660) 827-1488
NPI assigned
Aug 19, 2011
Organization subpart
Yes
Parent organization
BOTHWELL REGIONAL HEALTH CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 2, 2014

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

Authorized official

Name
Mr. James A Robertson Jr.
Title
Cfo
Phone
(660) 827-9482

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RC0000X Primary

Addresses

Primary practice location

3700 W 10TH Street
Suite 200
Sedalia, MO 65301-2540

Mailing address

601 E 14TH St
PO Box 1706
Sedalia, MO 65301-5972
Phone (866) 678-5627

Other identifiers 2

IdentifierTypeStateIssuer
45896011OtherMOBLUE CROSS
PENDINGMedicaidMO

Other names 1

  • Missouri Heart-Sedalia Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111108000566 MO Part B Supplier - Clinic/Group Practice 6608049697 Receives reassigned benefits from 10 practitioners
Practice locations: Sedalia, MO

National Provider Directory

National Provider Directory
Part of
Osage Valley Medical Ce

Practitioners & affiliated clinicians

Practitioners 11

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": "1313712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1417478400000",
    "number": "1528348786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 E 14TH ST",
            "address_2": "PO BOX 1706",
            "city": "SEDALIA",
            "state": "MO",
            "postal_code": "653015972",
            "telephone_number": "866-678-5627",
            "fax_number": "660-827-3742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 W 10TH STREET",
            "address_2": "SUITE 200",
            "city": "SEDALIA",
            "state": "MO",
            "postal_code": "653012540",
            "telephone_number": "660-827-1771",
            "fax_number": "660-827-1488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRHC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BOTHWELL REGIONAL HEALTH CENTER",
        "enumeration_date": "2011-08-19",
        "last_updated": "2014-12-02",
        "status": "A",
        "authorized_official_last_name": "ROBERTSON",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "660-827-9482",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "45896011",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Missouri Heart-Sedalia",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sedalia, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2014; 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.