NPIMap

Organization Active NPI

Ozarks Medical Center

Doing business as Ozarks Healthcare Internal Medicine

  • Rural Health Clinic/Center
  • West Plains, MO
National Provider Identifier
1750680146
Registry record updated May 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
OZARKS MEDICAL CENTER
Doing business as
Ozarks Healthcare Internal Medicine
Practice address
1115 Alaska St Ste 215
West Plains, MO 65775-2014
Phone
(417) 257-5989
Fax
(417) 256-1780
NPI assigned
Mar 24, 2011
Last updated
May 12, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 12, 2021

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

Authorized official

Name
Thomas Keller
Title
Ceo/President
Phone
(417) 256-9111

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X NU Primary
Internal Medicine Physician 207R00000X NU

Addresses

Primary practice location

1115 Alaska St Ste 215
West Plains, MO 65775-2014

Mailing address

PO Box 1100
West Plains, MO 65775-1100

Other names 1

  • Ozarks Healthcare Internal Medicine Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040209001035 MO Part B Supplier - Clinic/Group Practice 3870491863 Receives reassigned benefits from 353 practitioners
28 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: West Plains, MO; Winona, MO; Willow Springs, MO; Gainesville, MO; Houston, MO; Mountain Grove, MO; Mountain View, MO; Thayer, MO

Other NPIs on the same Medicare enrollment 28

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 28

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1300924800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620777600000",
    "number": "1750680146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1100",
            "city": "WEST PLAINS",
            "state": "MO",
            "postal_code": "657751100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 ALASKA ST STE 215",
            "city": "WEST PLAINS",
            "state": "MO",
            "postal_code": "657752014",
            "telephone_number": "417-257-5989",
            "fax_number": "417-256-1780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OZARKS MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-24",
        "last_updated": "2021-05-12",
        "certification_date": "2021-05-12",
        "status": "A",
        "authorized_official_last_name": "KELLER",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "417-256-9111"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ozarks Healthcare Internal Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in West Plains, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.