South Central Missouri Community Health Center

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

SOUTH CENTRAL MISSOURI COMMUNITY HEALTH CENTER

Practice address

1081 E 18TH St
Rolla, MO 65401-2448

Phone

(573) 458-8644

Fax

(573) 426-2263

NPI assigned

Oct 14, 2016

Organization subpart

No

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

Authorized official

Name

Amy Beechnermccarthy

Title

Ceo

Phone

(573) 458-8644

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Your Community Health Center Doing business as

Locations

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

{
    "created_epoch": "1476403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476403200000",
    "number": "1700337771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1081 E 18TH ST",
            "address_2": "PO BOX 458",
            "city": "ROLLA",
            "state": "MO",
            "postal_code": "654012448",
            "telephone_number": "573-458-8644",
            "fax_number": "573-426-2263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1081 E 18TH ST",
            "city": "ROLLA",
            "state": "MO",
            "postal_code": "654012448",
            "telephone_number": "573-458-8644",
            "fax_number": "573-426-2263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH CENTRAL MISSOURI COMMUNITY HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-14",
        "last_updated": "2016-10-14",
        "status": "A",
        "authorized_official_last_name": "BEECHNERMCCARTHY",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "573-458-8644"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1164669172",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Your Community Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• South Central Missouri Angels, LLC
• South Central Missouri Community Health Center
• South Central Missouri Community Health Center
• South Central Missouri Community Health Center
• South Central Missouri Community Health Center
• South Central Missouri Community Health Center
• South Central Missouri Community Health Center
• James J Spadaro Jr., M.D.
• Emma Sparks, LMSW
• James Mark Spaw, FNP-C

• Dentist in Rolla, MO
• Providers in Rolla, MO by specialty
• Dentist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2016; 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.