Mercy Clinic Springfield Communities

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

MERCY CLINIC SPRINGFIELD COMMUNITIES

Doing business as

Mercy Clinic Family Medicine Ava

Practice address

1312 North Highway 5
Ava, MO 65608

Phone

(417) 683-4045

Fax

(417) 683-6069

NPI assigned

Feb 23, 2007

Last updated

Apr 28, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Stuart G. Stangeland

Title

Senior Vice President, Coo

Phone

(417) 820-6556

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Mercy Clinic Family Medicine Ava Doing business as

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

CLIA laboratory certificates

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

{
    "created_epoch": "1172188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430179200000",
    "number": "1770618233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 505164",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631505164",
            "telephone_number": "417-820-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1312 NORTH HIGHWAY 5",
            "city": "AVA",
            "state": "MO",
            "postal_code": "65608",
            "telephone_number": "417-683-4045",
            "fax_number": "417-683-6069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY CLINIC SPRINGFIELD COMMUNITIES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-23",
        "last_updated": "2015-04-28",
        "status": "A",
        "authorized_official_last_name": "STANGELAND",
        "authorized_official_first_name": "STUART",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "SENIOR VICE PRESIDENT, COO",
        "authorized_official_telephone_number": "417-820-6556"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "113969",
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "MO",
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "122348",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "595879701",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mercy Clinic Family Medicine Ava",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Danny Maggard
• Kristen Maggard
• Mansfield Clinic, Inc. (Prime Care of Ava)
• Scott C. Mason, DDS
• Medical Equipment Inspection & Repair
• April Moody, LMSW
• Carolyn Marie Myers, OTR/L
• Andrea Naylor, GERONTOLOGIST
• Vicky J. Owens, FNP
• Ozark Mountain Compounding

• Rural Health Clinic/Center in Ava, MO
• Providers in Ava, MO by specialty
• Rural Health Clinic/Center in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.