Republic Family Medicine, LLC

Key facts

NPI: 1679980502
Entity type: Organization (NPI type 2)
Primary specialty: Family Medicine Physician 207Q00000X
Legal business name: REPUBLIC FAMILY MEDICINE, LLC
Practice address: 117 W State Highway 174
Republic, MO 65738-1036
Phone: (417) 647-5131
Fax: (417) 647-5168
NPI assigned: Jul 11, 2014
Organization subpart: No

Authorized official

Name: Dr. Yvonne Marie Agius, M.D. NPI 1699724708
Title: Member
Phone: (417) 824-0914

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 1

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

Yvonne Marie Agius, M.D. Family Medicine Physician · Republic, MO · NPI 1699724708

Medicare reassignment NPD Authorized official FAMILY MEDICINE · MO

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA number	Laboratory	Certificate	Expires
26D2120092	Republic Family Medicine LLC 117 W State Hwy 174, Republic, MO 65738	Certificate of waiver	Oct 10, 2026

Medicare participation

Medicare fee-for-service enrollment: Enrolled in MO

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
O20141205000315	MO	Part B Supplier - Clinic/Group Practice	0042532814	Receives reassigned benefits from 1 practitioner Practice locations: Republic, MO

National Provider Directory

Locations

117 W State Highway 174
Republic, MO 65738
Phone (417) 647-5131

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Family Medicine Physician Group: 193400000X SINGLE SPECIALTY GROUP	207Q00000X			Yes

Addresses

Primary practice location

117 W State Highway 174
Republic, MO 65738-1036

Mailing address

117 W State Highway 174
Republic, MO 65738-1036
Phone (417) 647-5131

Other identifiers

Identifier	Type	State	Issuer
1699724708	Medicaid	MO

Other providers in Republic, MO

Jaclyn Pohlers, DO
Marcia L Preston, DDS
Charise A Price, BSDC
Regional Services
Republic Family Medical Walk-in Clinics Inc
Republic Hearing Care LLC
Republic R-III
Amy Sue Ridenour, MSN, FNP-C
Riverbranch Healthcare, LLC
Madelyn Grace Robinson, PTA

All providers in Republic, MO · Family Medicine Physician in Missouri

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 2, 2023. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.