NPIMap

Organization Active NPI

Carter P Fenton Sr Clinics Inc

  • Family Medicine Physician
  • Chaffee, MO
National Provider Identifier
1750697322
Registry record updated Apr 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
31606 Issued in MO
Legal business name
CARTER P FENTON SR CLINICS INC
Practice address
206 S Main St
Chaffee, MO 63740-1002
Phone
(573) 887-3688
Fax
(573) 887-9022
NPI assigned
Aug 20, 2010
Last updated
Apr 3, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2019

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

Authorized official

Name
Carter P Fenton, DO
Title
President
Phone
(573) 887-3688

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 31606 MO Primary

Addresses

Primary practice location

206 S Main St
Chaffee, MO 63740-1002

Mailing address

PO Box 98
Chaffee, MO 63740-0098
Phone (573) 887-3688

Other identifiers 1

IdentifierTypeStateIssuer
240965905MedicaidMO

National Provider Directory

National Provider Directory

Locations

1001 Highway K
Ste 6
O Fallon, MO 63366
Phone (636) 447-4281

2630 Highway K
O Fallon, MO 63368
Phone (636) 240-5454

NPI Registry JSON

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

{
    "created_epoch": "1282262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554249600000",
    "number": "1750697322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 98",
            "city": "CHAFFEE",
            "state": "MO",
            "postal_code": "637400098",
            "telephone_number": "573-887-3688",
            "fax_number": "573-887-9022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 S MAIN ST",
            "city": "CHAFFEE",
            "state": "MO",
            "postal_code": "637401002",
            "telephone_number": "573-887-3688",
            "fax_number": "573-887-9022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARTER P FENTON SR CLINICS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-20",
        "last_updated": "2019-04-03",
        "status": "A",
        "authorized_official_last_name": "FENTON",
        "authorized_official_first_name": "CARTER",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "573-887-3688",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "31606",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "240965905",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chaffee, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2019; 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.