Organization Active NPI

Southwest Gastroenterology, LLC

  • Gastroenterology Physician
  • Joplin, MO
National Provider Identifier
1679686182
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
2006024391 Issued in MO
Legal business name
SOUTHWEST GASTROENTEROLOGY, LLC
Practice address
2817 MC Clelland Blvd
Suite 153
Joplin, MO 64804-1629
Phone
(417) 206-4928
Fax
(417) 206-4734
NPI assigned
Aug 17, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Xujun Wu, M.D.NPI 1235117425
Title
President
Phone
(330) 409-3337

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0100X 2006024391 MO Primary

Addresses

Primary practice location

2817 MC Clelland Blvd
Suite 153
Joplin, MO 64804-1629

Mailing address

2817 MC Clelland Blvd
Suite 153
Joplin, MO 64804-1629
Phone (417) 206-4928

National Provider Directory

National Provider Directory

Locations

2817 Mc Clelland Blvd
Ste 153
Joplin, MO 64804
Phone (417) 206-4928

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1679686182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2817 MC CLELLAND BLVD",
            "address_2": "SUITE 153",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648041629",
            "telephone_number": "417-206-4928",
            "fax_number": "417-206-4734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2817 MC CLELLAND BLVD",
            "address_2": "SUITE 153",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648041629",
            "telephone_number": "417-206-4928",
            "fax_number": "417-206-4734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST GASTROENTEROLOGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WU",
        "authorized_official_first_name": "XUJUN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "330-409-3337",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MO",
            "license": "2006024391",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Joplin, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.