Active NPI
Farmington Clinic Company LLC
- Family Medicine Physician
- Farmington, MO
National Provider Identifier
1750480885
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- FARMINGTON CLINIC COMPANY LLC
- Doing business as
- Mineral Area Primary Care
- Practice address
- 1101 Weber Rd
Suite 101
Farmington, MO 63640-3326 - Phone
- (573) 756-5701
- Fax
- (573) 756-7107
- NPI assigned
- Sep 22, 2006
- Organization subpart
- Yes
- Parent organization
- FARMINGTON CLINIC COMPANY LLC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Debbie E Brewer, MBA
- Title
- Director of Provider Enrollment
- Phone
- (877) 892-9813
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MO | Primary |
Addresses
Primary practice location
1101 Weber Rd
Suite 101
Farmington, MO 63640-3326
Mailing address
PO Box 504354
Saint Louis, MO 63150-0001
Phone (573) 756-5701
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 15057 | Other | MO | MEDICARE GROUP NUMBER |
Other names 1
- Mineral Area Primary Care
National Provider Directory
National Provider Directory- Part of
- Farmington Clinic Company L
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158883200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1658361600000",
"number": "1750480885",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 504354",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631500001",
"telephone_number": "573-756-5701",
"fax_number": "573-756-7107"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1101 WEBER RD",
"address_2": "SUITE 101",
"city": "FARMINGTON",
"state": "MO",
"postal_code": "636403326",
"telephone_number": "573-756-5701",
"fax_number": "573-756-7107"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FARMINGTON CLINIC COMPANY LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "FARMINGTON CLINIC COMPANY LLC",
"enumeration_date": "2006-09-22",
"last_updated": "2022-07-21",
"status": "A",
"authorized_official_last_name": "BREWER",
"authorized_official_first_name": "DEBBIE",
"authorized_official_middle_name": "E",
"authorized_official_title_or_position": "DIRECTOR OF PROVIDER ENROLLMENT",
"authorized_official_telephone_number": "877-892-9813",
"authorized_official_credential": "MBA"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Family Medicine",
"state": "MO",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE GROUP NUMBER",
"identifier": "15057",
"state": "MO"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Mineral Area Primary Care",
"code": "3",
"type": "Doing Business As"
}
]
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.