NPIMap

Organization Active NPI

Mercy Clinic Springfield Communities

  • Durable Medical Equipment & Medical Supplies
  • Ozark, MO
National Provider Identifier
1760936264
Registry record updated Dec 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
MERCY CLINIC SPRINGFIELD COMMUNITIES
Practice address
505 N 25TH St
Ozark, MO 65721-9069
Phone
(417) 820-9393
Fax
(417) 731-3393
NPI assigned
Aug 12, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2023

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

Authorized official

Name
William J Roberts
Title
Cfo
Phone
(417) 820-7363

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 2016020876 MO
Durable Medical Equipment & Medical Supplies 332B00000X MO Primary

Addresses

Primary practice location

505 N 25TH St
Ozark, MO 65721-9069

Mailing address

505 N 25TH St
Ozark, MO 65721-9069
Phone (417) 731-3395

Other names 1

  • Mercy Clinic Eye Specialists Optometry Ozark Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031218000354 MO Part B Supplier - Clinic/Group Practice 7416865845 Receives reassigned benefits from 1,639 practitioners
29 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
O20170216002871 MO DME Supplier - Physician - OptometristDME Supplier - Optician 7416865845 Practice locations: Ozark, MO

Other NPIs on the same Medicare enrollment 29

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

View all 29

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Eye Specialists Optical Shop Ozark505 N 25TH St, Ozark, MO 65721-9069(417) 820-9393 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses Accepts assignmentParticipating since Dec 5, 2022

National Provider Directory

National Provider Directory
Tax ID family
Springfield Clinic Nucl55 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1470960000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702252800000",
    "number": "1760936264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 N 25TH ST",
            "city": "OZARK",
            "state": "MO",
            "postal_code": "657219069",
            "telephone_number": "417-731-3395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 N 25TH ST",
            "city": "OZARK",
            "state": "MO",
            "postal_code": "657219069",
            "telephone_number": "417-820-9393",
            "fax_number": "417-731-3393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY CLINIC SPRINGFIELD COMMUNITIES",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-12",
        "last_updated": "2023-12-11",
        "certification_date": "2023-12-11",
        "status": "A",
        "authorized_official_last_name": "ROBERTS",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "417-820-7363"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MO",
            "license": "2016020876",
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MO",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mercy Clinic Eye Specialists Optometry Ozark",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Mercy Clinic Eye Specialists Optometry Ozark",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Ozark, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.