NPIMap

Organization Active NPI

Scott City Medical Clinic LLC

  • Clinic/Center
  • Scott City, MO
National Provider Identifier
1699472399
Registry record updated Feb 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
SCOTT CITY MEDICAL CLINIC LLC
Practice address
2102 Main St
Scott City, MO 63780-1337
Phone
(573) 264-0042
Fax
(573) 264-0087
NPI assigned
Feb 13, 2023
Last updated
Feb 13, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2023

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

Authorized official

Name
Kevin W McCallum
Title
Ceo
Phone
(573) 264-0042

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X NU Primary

Addresses

Primary practice location

2102 Main St
Scott City, MO 63780-1337

Mailing address

2102 Main St
Scott City, MO 63780-1337
Phone (573) 264-0042

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 4

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": "1676246400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676246400000",
    "number": "1699472399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2102 MAIN ST",
            "city": "SCOTT CITY",
            "state": "MO",
            "postal_code": "637801337",
            "telephone_number": "573-264-0042",
            "fax_number": "573-264-0087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2102 MAIN ST",
            "city": "SCOTT CITY",
            "state": "MO",
            "postal_code": "637801337",
            "telephone_number": "573-264-0042",
            "fax_number": "573-264-0087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCOTT CITY MEDICAL CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-13",
        "last_updated": "2023-02-13",
        "certification_date": "2023-02-13",
        "status": "A",
        "authorized_official_last_name": "MCCALLUM",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "573-264-0042"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scott City, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2023; 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.