NPIMap

Organization Active NPI

Boone Physician Services, LLC

  • Multi-Specialty Clinic/Center
  • Columbia, MO
National Provider Identifier
1760893259
Registry record updated Mar 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
BOONE PHYSICIAN SERVICES, LLC
Practice address
1600 E Broadway
Columbia, MO 65201-5844
Phone
(573) 815-6245
Fax
(573) 815-8556
NPI assigned
May 19, 2014
Last updated
Mar 15, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
BOONE HOSPITAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 15, 2021

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

Authorized official

Name
Mr. Brian Lee Winn
Title
Director of Finance
Phone
(573) 815-3269

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

1600 E Broadway
Columbia, MO 65201-5844

Mailing address

1600 E Broadway
Columbia, MO 65201-5844
Phone (573) 815-6245

Other names 1

  • CHAS Cardiology Services, LLC Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, NH, KY, OK, ME, TN, MT, TX, NC, OR, WI, KS12 enrollments

Enrollment records 12

Enrollment IDStateProvider typePAC IDDetails
O20131003000535 MO Part B Supplier - Clinic/Group Practice 6507090644 Receives reassigned benefits from 317 practitioners
1 other NPI on this enrollment
Practice locations: Fulton, MO; Fayette, MO; Columbia, MO; Glasgow, MO; Hallsville, MO; Jefferson City, MO; Kirksville, MO; Linn, MO…
O20240131001318 NH Part B Supplier - Clinic/Group Practice 6507090644 Practice locations: Hampton, NH
O20240205001129 KY Part B Supplier - Clinic/Group Practice 6507090644 Practice locations: Maysville, KY; Paducah, KY
O20240212003473 OK Part B Supplier - Clinic/Group Practice 6507090644 Practice locations: Marietta, OK
O20240219002420 ME Part B Supplier - Clinic/Group Practice 6507090644 Practice locations: Portland, ME
O20240228003863 TN Part B Supplier - Clinic/Group Practice 6507090644 Practice locations: Signal Mountain, TN
O20240301002488 MT Part B Supplier - Clinic/Group Practice 6507090644 Practice locations: Big Sky, MT
O20240304001243 TX Part B Supplier - Clinic/Group Practice 6507090644 Receives reassigned benefits from 1 practitioner
Practice locations: Austin, TX; Kyle, TX
O20240305001830 NC Part B Supplier - Clinic/Group Practice 6507090644 Practice locations: Cary, NC
O20240320000164 OR Part B Supplier - Clinic/Group Practice 6507090644 Practice locations: Albany, OR
O20250108001923 WI Part B Supplier - Clinic/Group Practice 6507090644 Receives reassigned benefits from 1 practitioner
Practice locations: La Crosse, WI
O20250304001994 KS Part B Supplier - Clinic/Group Practice 6507090644 Receives reassigned benefits from 1 practitioner
Practice locations: Emporia, KS; Overland Park, KS

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Part of
CH Allied Services

Locations

396 W US Highway 54
Camdenton, MO 65020
Phone (573) 317-0111

1600 E Broadway
#50
Columbia, MO 65201

1600 E Broadway
Ste 110
Columbia, MO 65201
Phone (573) 875-8838

1601 E Broadway
Ste 260
Columbia, MO 65201
Phone (573) 815-2221

1601 E Broadway
Ste 350
Columbia, MO 65201
Phone (573) 815-2970

1701 E Broadway
Ste 106
Columbia, MO 65201
Phone (573) 449-5565

1701 E Broadway
Ste 260
Columbia, MO 65201
Phone (573) 815-5310

1705 E Broadway
Ste 280
Columbia, MO 65201
Phone (573) 815-7119

1705 Christy Dr
Ste 200
Jefferson Cty, MO 65101
Phone (573) 634-3338

1108 E Patterson St
Ste 6
Kirksville, MO 63501
Phone (660) 665-5333

2100 Silva Ln
Ste B
Moberly, MO 65270
Phone (660) 263-6223

5780 Osage Beach Pkwy
Ste 220
Osage Beach, MO 65065
Phone (573) 636-5285

601 Kingshighway St
Ste A
Rolla, MO 65401
Phone (573) 368-0999

24530 Southside Rd
Ste E
Waynesville, MO 65583
Phone (573) 774-3666

Practitioners & affiliated clinicians

Practitioners 364

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.

View all 364

NPI Registry JSON

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

{
    "created_epoch": "1400457600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615766400000",
    "number": "1760893259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 E BROADWAY",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652015844",
            "telephone_number": "573-815-6245",
            "fax_number": "573-815-8556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 E BROADWAY",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652015844",
            "telephone_number": "573-815-6245",
            "fax_number": "573-815-8556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOONE PHYSICIAN SERVICES, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BOONE HOSPITAL CENTER",
        "enumeration_date": "2014-05-19",
        "last_updated": "2021-03-15",
        "certification_date": "2021-03-15",
        "status": "A",
        "authorized_official_last_name": "WINN",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "DIRECTOR OF FINANCE",
        "authorized_official_telephone_number": "573-815-3269",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CHAS Cardiology Services, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "CHAS Cardiology Services, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Columbia, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 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.