Liberty Medical Center, PC

Primary specialty

Non-Pharmacy Dispensing SiteTaxonomy code 332900000X

Legal business name

LIBERTY MEDICAL CENTER, PC

Practice address

1504 NE 96TH St Ste a
Liberty, MO 64068-1351

Phone

(816) 415-2233

Fax

(816) 415-2218

NPI assigned

Dec 8, 2011

Last updated

Mar 20, 2026By the provider in NPPES

Organization subpart

Yes

Parent organization

LIBERTY MEDICAL CENTER PCAs reported in NPPES

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

Authorized official

Name

Shelly Boomgaarden

Title

Billing

Phone

(816) 415-2233

Specialties & licenses 1

Addresses

Part of

Liberty Medical Center PC

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.

• Liberty Medical Center PC

  • Primary Care Clinic/Center
  • Liberty, MO
  • NPI 1679777908
  NPPES parent name

Practitioners 3

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.

• Melinda Heutinck, ANP-C, PMHNP-C

  • Adult Health Nurse Practitioner
  • Liberty, MO
  • NPI 1912178575
  NPD
• Rodney James Malisos, M.D.

  • Family Medicine Physician
  • Liberty, MO
  • NPI 1497753545
  NPD (past)
• Melissa Renee Laycock, APRN FNP-BC

  • Family Nurse Practitioner
  • Shawnee, KS
  • NPI 1487952966
  NPD (past)

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

{
    "created_epoch": "1323302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773964800000",
    "number": "1609144450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2980 N BEVERLY GLEN CIR STE 100",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900771728",
            "telephone_number": "310-474-9809",
            "fax_number": "888-431-8819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1504 NE 96TH ST STE A",
            "city": "LIBERTY",
            "state": "MO",
            "postal_code": "640681351",
            "telephone_number": "816-415-2233",
            "fax_number": "816-415-2218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBERTY MEDICAL CENTER, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LIBERTY MEDICAL CENTER PC",
        "enumeration_date": "2011-12-08",
        "last_updated": "2026-03-20",
        "certification_date": "2026-03-20",
        "status": "A",
        "authorized_official_last_name": "BOOMGAARDEN",
        "authorized_official_first_name": "SHELLY",
        "authorized_official_title_or_position": "BILLING",
        "authorized_official_telephone_number": "816-415-2233"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Liberty Emergency Physicians, Inc.
• Liberty Home Care LLC
• Liberty Hospital Emergency Medicine Physicians, LLC
• Liberty Hospital Physician Clinics
• Liberty Medical Center PC
• Liberty Medicine Specialists, Inc.
• Liberty Neurology, LLC
• Liberty Orthopedic Associates, P.C. (Liberty Orthopedics)
• Liberty Orthopedic Associates, P.C.
• Liberty Park Chiropractic, LLC

• Non-Pharmacy Dispensing Site in Liberty, MO
• Providers in Liberty, MO by specialty
• Non-Pharmacy Dispensing Site in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2026; 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.