McPherson Medical & Diagnostic LLC
Organization Active NPI Clinic/Center · Carthage, MO
NPI 1700569670 · NPPES record last updated Aug 8, 2023
Key facts
- NPI
- 1700569670
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinic/Center 261Q00000X
- Legal business name
- MCPHERSON MEDICAL & DIAGNOSTIC LLC
- Practice address
- 1515 Hazel Ave
Carthage, MO 64836-2850 - Phone
- (417) 358-4685
- NPI assigned
- Aug 8, 2023
- Organization subpart
- No
Authorized official
- Name
- Abdullah Arshad
- Title
- MD
- Phone
- (573) 724-0083
Other NPIs on the same Medicare enrollment 23
Corporate family (same tax ID) 36
Practitioners 12
-
Margaret C Hart, NP
-
Jonathan Lyle Manzer, M.D.
-
Beth Mettes, FNP-BC
-
Courtney Johnston, APRN-C
-
Jody M Pryor, APRN
-
McKenzie Elizabeth Turner, MSN, APRN, FNP-C
-
Kristin Diane Wagner, A.P.R.N.
-
Susan Zhou, FNP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20061201000167 | MO | Part B Supplier - Clinic/Group Practice | 5698773539 |
Receives reassigned benefits from 116 practitioners 23 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Kennett, MO; Macon, MO; Malden, MO; Saint Louis, MO; Saint Peters, MO; Scott City, MO; Steele, MO; Moberly, MO… |
National Provider Directory
- Tax ID family
- McPherson Medical Diagnostic LLC
Locations
3069 S Grand Ave
Carthage, MO 64836
Phone (417) 356-3030
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | Yes |
Addresses
Primary practice location
1515 Hazel Ave
Carthage, MO 64836-2850
Mailing address
1515 Hazel Ave
Carthage, MO 64836-2850
Phone (417) 358-4685
Other names
- American Medical Missouri
Other providers in Carthage, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 8, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.