St Johns Clinic Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

ST JOHNS CLINIC INC

Doing business as

SJC-Mountain Grove

Practice address

120 W 16TH St
Mountain Grove, MO 65711-1039

Phone

(417) 926-6111

Fax

(417) 926-6115

NPI assigned

Apr 9, 2007

Last updated

Jun 30, 2008By 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

Donn E. Sorensen

Title

Senior Vice President

Phone

(417) 829-4264

Specialties & licenses 1

Addresses

Other names 1

• SJC-Mountain Grove Doing business as

Locations

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

{
    "created_epoch": "1176076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214784000000",
    "number": "1780707406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2580",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658012580",
            "telephone_number": "417-829-4620",
            "fax_number": "417-829-4316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 W 16TH ST",
            "city": "MOUNTAIN GROVE",
            "state": "MO",
            "postal_code": "657111039",
            "telephone_number": "417-926-6111",
            "fax_number": "417-926-6115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST JOHNS CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-09",
        "last_updated": "2008-06-30",
        "status": "A",
        "authorized_official_last_name": "SORENSEN",
        "authorized_official_first_name": "DONN",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "SENIOR VICE PRESIDENT",
        "authorized_official_telephone_number": "417-829-4264"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MO",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SJC-Mountain Grove",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Katie J Shannon, ATC/LAT
• Deborah Ann Shockley, L.P.C.
• Jeremy Ryan Skeen, P.T.
• Francis Louise Smith, ADMINISTRATOR
• Spurling and White LLC (Grove Family Care)
• Mary Ellen Stephenson, BSPT
• Micheala Stewart, APRN, FNP-C
• Sheri L Stofer, PA-C
• James R Stovall, PT,ATC,CSCS
• Paula Sykes, MS

• Durable Medical Equipment & Medical Supplies in Mountain Grove, MO
• Providers in Mountain Grove, MO by specialty
• Durable Medical Equipment & Medical Supplies in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2008; 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.