NPIMap

Organization Active NPI

Northwest Medical Center Association, Inc.

  • Family Medicine Physician
  • Albany, MO
National Provider Identifier
1548424757
Registry record updated Sep 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
104860 Issued in MO
Legal business name
NORTHWEST MEDICAL CENTER ASSOCIATION, INC.
Practice address
402 E US Highway 136
NMC Albany Clinic West
Albany, MO 64402-8210
Phone
(660) 726-3311
NPI assigned
Jul 16, 2008
Last updated
Sep 12, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
NORTHWEST MEDICAL CENTER ASSOCIATION, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 12, 2024

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

Authorized official

Name
Dwight Carvell
Title
Director of Reimbursement
Phone
(816) 273-0437

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 104860 MO Primary

Addresses

Primary practice location

402 E US Highway 136
NMC Albany Clinic West
Albany, MO 64402-8210

Mailing address

705 N College St
Northwest Medical Center
Albany, MO 64402-1433
Phone (660) 726-3941

Other identifiers 1

IdentifierTypeStateIssuer
MA1249OtherMOMEDICARE PTAN

Other names 1

  • NMC Albany Clinic West Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040224000204 MO Part B Supplier - Clinic/Group Practice 5496641896 Receives reassigned benefits from 205 practitioners
8 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Albany, MO; Grant City, MO; New Hampton, MO; Stanberry, MO

Other NPIs on the same Medicare enrollment 8

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

National Provider Directory

National Provider Directory
Part of
Albany Physician Clinic

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1216166400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726099200000",
    "number": "1548424757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 N COLLEGE ST",
            "address_2": "NORTHWEST MEDICAL CENTER",
            "city": "ALBANY",
            "state": "MO",
            "postal_code": "644021433",
            "telephone_number": "660-726-3941",
            "fax_number": "660-726-3647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 E US HIGHWAY 136",
            "address_2": "NMC ALBANY CLINIC WEST",
            "city": "ALBANY",
            "state": "MO",
            "postal_code": "644028210",
            "telephone_number": "660-726-3311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST MEDICAL CENTER ASSOCIATION, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORTHWEST MEDICAL CENTER ASSOCIATION, INC.",
        "enumeration_date": "2008-07-16",
        "last_updated": "2024-09-12",
        "certification_date": "2024-09-12",
        "status": "A",
        "authorized_official_last_name": "CARVELL",
        "authorized_official_first_name": "DWIGHT",
        "authorized_official_title_or_position": "DIRECTOR OF REIMBURSEMENT",
        "authorized_official_telephone_number": "816-273-0437"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "104860",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "MA1249",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NMC Albany Clinic West",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Albany, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2024; 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.