Liberty Medical Center PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

2000146367 Issued in MO

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

Jun 12, 2007

Organization subpart

No

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

Authorized official

Name

Brianne Merideth

Title

Billing

Phone

(816) 415-2233

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Liberty Medical Center, PC

  • Non-Pharmacy Dispensing Site
  • Liberty, MO
  • NPI 1609144450
  NPPES parent name

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Melinda Heutinck, ANP-C, PMHNP-C

  • Adult Health Nurse Practitioner
  • Liberty, MO
  • NPI 1912178575
  Medicare reassignment Care Compare group NPD
• Rodney James Malisos, M.D.

  • Family Medicine Physician
  • Liberty, MO
  • NPI 1497753545
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1181606400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773964800000",
    "number": "1679777908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "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"
        },
        {
            "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": "NO",
        "enumeration_date": "2007-06-12",
        "last_updated": "2026-03-20",
        "certification_date": "2026-03-20",
        "status": "A",
        "authorized_official_last_name": "MERIDETH",
        "authorized_official_first_name": "BRIANNE",
        "authorized_official_title_or_position": "BILLING",
        "authorized_official_telephone_number": "816-415-2233"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2000146367",
            "primary": true
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "205388101",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "40035011",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Liberty Chiropractic Center LLC
• 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 Orthopedic Associates, P.C.

• Family Medicine Physician in Liberty, MO
• Providers in Liberty, MO by specialty
• Family Medicine Physician 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.
• 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.