NPIMap

Organization Active NPI

Farmington Ear, Nose, and Throat, LLC

  • Medical Specialty Clinic/Center
  • Farmington, MO
National Provider Identifier
1740451491
Registry record updated Mar 4, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
Legal business name
FARMINGTON EAR, NOSE, AND THROAT, LLC
Practice address
501 West Pine Street
Farmington, MO 63640
Phone
(573) 756-8888
Fax
(866) 291-5617
NPI assigned
Mar 20, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2009

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

Authorized official

Name
Dr. Justin W. Roberts, D.O.
Title
Owner
Phone
(573) 756-8888

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X Primary

Addresses

Primary practice location

501 West Pine Street
Farmington, MO 63640

Mailing address

501 W Pine St
Farmington, MO 63640
Phone (573) 756-8888

National Provider Directory

National Provider Directory

Locations

501 W Pine St
Farmington, MO 63640
Phone (573) 756-8888

NPI Registry JSON

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

{
    "created_epoch": "1205971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1236124800000",
    "number": "1740451491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 W PINE ST",
            "city": "FARMINGTON",
            "state": "MO",
            "postal_code": "63640",
            "telephone_number": "573-756-8888",
            "fax_number": "866-291-5617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 WEST PINE STREET",
            "city": "FARMINGTON",
            "state": "MO",
            "postal_code": "63640",
            "telephone_number": "573-756-8888",
            "fax_number": "866-291-5617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FARMINGTON EAR, NOSE, AND THROAT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-20",
        "last_updated": "2009-03-04",
        "status": "A",
        "authorized_official_last_name": "ROBERTS",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "573-756-8888",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2009; 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.