Tri County Medical Clinic P C

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

R8G92 Issued in MO

Legal business name

TRI COUNTY MEDICAL CLINIC P C

Practice address

208 N Ogden St
Box 367
Sturgeon, MO 65284-9217

Phone

(573) 687-3411

Fax

(573) 687-3328

NPI assigned

Jan 22, 2009

Last updated

Jan 22, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Alan M Weaver, D.O.NPI 1407844962

Title

Medical Director

Phone

(573) 687-3411

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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.

• Alan M Weaver, D.O.

  • Family Medicine Physician
  • Sturgeon, MO
  • NPI 1407844962
  Authorized official Same address or phone

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

{
    "created_epoch": "1232582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1232582400000",
    "number": "1639317050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6601 W THORNHILL RD",
            "city": "CLARK",
            "state": "MO",
            "postal_code": "652439381",
            "telephone_number": "573-687-3411",
            "fax_number": "573-687-3328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 N OGDEN ST",
            "address_2": "BOX 367",
            "city": "STURGEON",
            "state": "MO",
            "postal_code": "652849217",
            "telephone_number": "573-687-3411",
            "fax_number": "573-687-3328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI COUNTY MEDICAL CLINIC P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-22",
        "last_updated": "2009-01-22",
        "status": "A",
        "authorized_official_last_name": "WEAVER",
        "authorized_official_first_name": "ALAN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "573-687-3411",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "MO",
            "license": "R8G92",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "242429009",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Janice Kay Skinner, MA SLP CCC
• Sturgeon Medical Clinic PC
• Sturgeon R-V School
• Sturgeon Rest Home, LLC
• Sturgeon Rest Residential Care LLC
• Alan M Weaver, D.O.

• Primary Care Clinic/Center in Sturgeon, MO
• Providers in Sturgeon, MO by specialty
• Primary Care Clinic/Center in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2009; 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.