NPIMap

Organization Active NPI

Ozarks Medical Center

  • Community/Behavioral Health Agency
  • West Plains, MO
National Provider Identifier
1689880973
Registry record updated Jul 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
147-48 Issued in MO
Legal business name
OZARKS MEDICAL CENTER
Practice address
1211 Porter Wagoner Blvd # 23
West Plains, MO 65775-1826
Phone
(417) 257-6762
Fax
(417) 257-5875
NPI assigned
May 15, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2024

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

Authorized official

Name
Thomas Keller
Title
President
Phone
(417) 257-9111

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 147-48 MO Primary

Addresses

Primary practice location

1211 Porter Wagoner Blvd # 23
West Plains, MO 65775-1826

Mailing address

PO Box 1100
West Plains, MO 65775-1100

Other identifiers 1

IdentifierTypeStateIssuer
87175605MedicaidMO

Other names 1

  • OMC ADULT CPRC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Omc Breast Care45 organizations share this tax ID, including this one

Other organizations with this tax ID 44

Organizations that report the same tax identification number in the National Provider Directory.

View all 44

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721174400000",
    "number": "1689880973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1100",
            "city": "WEST PLAINS",
            "state": "MO",
            "postal_code": "657751100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1211 PORTER WAGONER BLVD # 23",
            "city": "WEST PLAINS",
            "state": "MO",
            "postal_code": "657751826",
            "telephone_number": "417-257-6762",
            "fax_number": "417-257-5875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OZARKS MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-15",
        "last_updated": "2024-07-17",
        "certification_date": "2024-07-17",
        "status": "A",
        "authorized_official_last_name": "KELLER",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "417-257-9111"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MO",
            "license": "147-48",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "87175605",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OMC ADULT CPRC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in West Plains, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2024; 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.