Valley Medical Center P.C.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

VALLEY MEDICAL CENTER P.C.

Practice address

308 S Harris St
Willow Springs, MO 65793-1621

Phone

(417) 469-3175

Fax

(417) 469-1274

NPI assigned

Jun 17, 2006

Organization subpart

No

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

Authorized official

Name

Mr. William E Berner

Title

Clinic Administrator

Phone

(989) 892-7722

Specialties & licenses 2

Addresses

Other identifiers 5

Locations

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

{
    "created_epoch": "1150502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1408492800000",
    "number": "1740225598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "308 S HARRIS ST",
            "city": "WILLOW SPRINGS",
            "state": "MO",
            "postal_code": "657931621",
            "telephone_number": "417-469-3175",
            "fax_number": "989-892-7455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 S HARRIS ST",
            "city": "WILLOW SPRINGS",
            "state": "MO",
            "postal_code": "657931621",
            "telephone_number": "417-469-3175",
            "fax_number": "417-469-1274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALLEY MEDICAL CENTER P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-17",
        "last_updated": "2014-08-20",
        "status": "A",
        "authorized_official_last_name": "BERNER",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CLINIC ADMINISTRATOR",
        "authorized_official_telephone_number": "989-892-7722",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "205784",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "598649408",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "112904",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAHABA GBA",
            "identifier": "263871",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "P00163042",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Willow Springs, MO
• Providers in Willow Springs, MO by specialty
• Family Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2014; 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.