NPIMap

Organization Active NPI

Capital Region Medical Center

Doing business as Capital Region Physicians - Holts Summit

  • Family Medicine Physician
  • Holts Summit, MO
National Provider Identifier
1710959598
Registry record updated Aug 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
CAPITAL REGION MEDICAL CENTER
Doing business as
Capital Region Physicians - Holts Summit
Practice address
180 Northstar St
Holts Summit, MO 65043-1123
Phone
(573) 896-5115
Fax
(573) 896-4272
NPI assigned
Feb 6, 2006
Last updated
Aug 23, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2013

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

Authorized official

Name
Tom Luebbering
Title
VP of Finance
Phone
(573) 632-5100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

180 Northstar St
Holts Summit, MO 65043-1123

Mailing address

180 Northstar St
Holts Summit, MO 65043-1123
Phone (573) 896-5115

Other identifiers 1

IdentifierTypeStateIssuer
501607808MedicaidMO

Other names 1

  • Capital Region Physicians - Holts Summit Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Capital Region Medical Center47 organizations share this tax ID, including this one

Other organizations with this tax ID 46

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

View all 46

Locations

180 Northstar Dr
Holts Summit, MO 65043
Phone (573) 896-5115

NPI Registry JSON

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

{
    "created_epoch": "1139184000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1377216000000",
    "number": "1710959598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 NORTHSTAR ST",
            "city": "HOLTS SUMMIT",
            "state": "MO",
            "postal_code": "650431123",
            "telephone_number": "573-896-5115",
            "fax_number": "573-896-4272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 NORTHSTAR ST",
            "city": "HOLTS SUMMIT",
            "state": "MO",
            "postal_code": "650431123",
            "telephone_number": "573-896-5115",
            "fax_number": "573-896-4272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAPITAL REGION MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-06",
        "last_updated": "2013-08-23",
        "status": "A",
        "authorized_official_last_name": "LUEBBERING",
        "authorized_official_first_name": "TOM",
        "authorized_official_title_or_position": "VP OF FINANCE",
        "authorized_official_telephone_number": "573-632-5100"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "501607808",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Capital Region Physicians - Holts Summit",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Holts Summit, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2013; 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.