Midwest OB GYN of Missouri, L.L.C.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

Legal business name

MIDWEST OB GYN OF MISSOURI, L.L.C.

Practice address

2210 Barron Rd
Poplar Bluff, MO 63901-1908

Phone

(573) 686-4133

Fax

(573) 686-1315

NPI assigned

May 19, 2006

Organization subpart

No

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

Authorized official

Name

Dr. John R Patty, D.O.NPI 1326094566

Title

Physician

Phone

(573) 772-7000

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Midwest OB GYN of Missouri, LLC

  • Rural Health Clinic/Center
  • Poplar Bluff, MO
  • NPI 1396337473

  3870853294

  Same PAC ID

Tax ID family

Midwest OB GYN of Missouri LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Midwest OB GYN of Missouri, LLC

  • Rural Health Clinic/Center
  • Poplar Bluff, MO
  • NPI 1396337473
  NPD tax ID

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.

• Midwest OB GYN of Missouri, LLC

  • Rural Health Clinic/Center
  • Poplar Bluff, MO
  • NPI 1396337473
  NPPES parent name

Practitioners 2

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

• John R Patty, D.O.

  • Obstetrics & Gynecology Physician
  • Poplar Bluff, MO
  • NPI 1326094566
  Medicare reassignment Care Compare group Authorized official
• Sandy D Johns, WHNP-BC

  • Obstetrics & Gynecology Nurse Practitioner
  • Poplar Bluff, MO
  • NPI 1578908091
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616716800000",
    "number": "1699728543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2210 BARRON RD",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639011908",
            "telephone_number": "573-686-4133",
            "fax_number": "573-686-1315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2210 BARRON RD",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639011908",
            "telephone_number": "573-686-4133",
            "fax_number": "573-686-1315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWEST OB GYN OF MISSOURI, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-19",
        "last_updated": "2021-03-26",
        "certification_date": "2021-03-26",
        "status": "A",
        "authorized_official_last_name": "PATTY",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "573-772-7000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "243029600",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael G Michel, B.S., D.C.
• Mid-Land Anesthesia Associates
• Mid-South Health Clinic LLC
• Midwest Equipment SRV Systems LLC
• Midwest Health Care, LLC
• Midwest OB GYN of Missouri, LLC
• Midwest Therapy Services
• Robert H Mielke, CRNA
• Tabitha Mikel
• Joshua Dale Milam, APRN

• Obstetrics & Gynecology Physician in Poplar Bluff, MO
• Providers in Poplar Bluff, MO by specialty
• Obstetrics & Gynecology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2021; 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.