Boone Physician Services, LLC
Organization Active NPI Multi-Specialty Clinic/Center · Columbia, MO
NPI 1760893259 · NPPES record last updated Mar 15, 2021
Key facts
- NPI
- 1760893259
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Multi-Specialty Clinic/Center 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
- Organization subpart
- Yes
- Parent organization (as reported)
- BOONE HOSPITAL CENTER
Authorized official
- Name
- Mr. Brian Lee Winn
- Title
- Director of Finance
- Phone
- (573) 815-3269
Other NPIs with the same Medicare PAC ID 4
Practitioners 366
-
Tareq M. Abu Salah, M.D.
-
Sonya Addison, M.D.
-
Sadiat Omowunmi Adebiyi, APRN
-
Saqib Ahmed, MD
-
Todd M Ankenman, PT
-
Marikay Lou Asberry, MSPT/ATC
-
Kellie Marie Asher, DPT
-
Phillip P. Beck, M.D.
-
Lindsay Allison Bell, P.T.
-
Shambhu Bhagat, M.D.
-
Kanchan Bhattarai, AANP
-
Charles P. Bondurant, M.D.
-
Holly M Boyer, MD
-
Rachael Nichole Brashears, D.O., MBA
-
Lauren Wood Breshears, N.P.
-
Julie Marie Bresnahan, FNP-BC
-
Rodney Creedan Brownell, P.T.
-
Lisa M Byrd, FNP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (12 enrollments) in MO, NH, KY, OK, ME, TN, MT, TX, NC, OR, WI, KS
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 |
National Provider Directory
- Part of
- Marceline Family Health
Locations
603 S Henry Clay Blvd
Ste B
Ashland, MO 65010
Phone (573) 657-1915
1921 Boone Village Plz
Boonville, MO 65233
Phone (660) 672-7077
396 W US Highway 54
Camdenton, MO 65020
Phone (573) 317-0111
1705 E Broadway
Ste 300
Columbia, MO 65201
Phone (573) 449-9355
1601 E Broadway
Ste 350
Columbia, MO 65201
Phone (573) 443-8796
1605 E Broadway
Ste 210
Columbia, MO 65201
Phone (573) 815-2236
1705 E Broadway
Ste 280
Columbia, MO 65201
Phone (573) 815-7119
900 W Nifong Blvd
Ste 100
Columbia, MO 65203
Phone (573) 815-6631
1701 E Broadway
Ste 302
Columbia, MO 65201
Phone (573) 815-7146
1701 E Broadway
Ste 260
Columbia, MO 65201
Phone (573) 815-5310
1601 E Broadway
Ste 260
Columbia, MO 65201
Phone (573) 815-2221
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
24530 Southside Rd
Ste E
Waynesville, MO 65583
Phone (573) 774-3666
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Multi-Specialty Clinic/Center | 261QM1300X | Yes |
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 identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| DU1604 | Other | MO | RAILROAD MEDICARE |
Other names
- CHAS Cardiology Services, LLC
Other providers in Columbia, MO
- Boone Health Supplies
- Boone Hospital Center'S Visiting Nurses, Inc
- Boone Hospital Center'S Visiting Nurses, Inc.
- Boone Hospital Center'S Visiting Nurses, Inc.
- Boone Physician Services, LLC
- Kendyl Renee Boone
- Cole Borchardt
- Camille Elise Bordelon
- Christal C Borden
- Meelie Bordoloi
All providers in Columbia, MO · Multi-Specialty Clinic/Center in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 15, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.