Mid-Missouri Neonatology LLC

Primary specialty

Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X

Legal business name

MID-MISSOURI NEONATOLOGY LLC

Practice address

1600 E Broadway
Columbia, MO 65201-5844

Phone

(573) 815-3737

Fax

(573) 815-3716

NPI assigned

Nov 9, 2006

Last updated

Aug 22, 2020By 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

Ms. Brenda Lee Wilson

Title

Insurance and Billing Specialist

Phone

(573) 815-9700

Specialties & licenses 1

Addresses

Other identifiers 3

Practitioners 2

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.

• Timothy Allen O'Connor, M.D.

  • Neonatal-Perinatal Medicine Physician
  • Columbia, MO
  • NPI 1215016621
  NPD (past)
• Laura Ann O'Gorman, M.D.

  • Neonatal-Perinatal Medicine Physician
  • Columbia, MO
  • NPI 1114000957
  NPD (past)

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1831269695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10200",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652054003",
            "telephone_number": "573-815-9700",
            "fax_number": "573-815-0700"
        },
        {
            "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": "573-815-3737",
            "fax_number": "573-815-3716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID-MISSOURI NEONATOLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "INSURANCE AND BILLING SPECIALIST",
        "authorized_official_telephone_number": "573-815-9700",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS GROUP PIN",
            "identifier": "129002",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHP GROUP PIN",
            "identifier": "26831",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH CARE USA GROUP PIN",
            "identifier": "19413",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Neonatal-Perinatal Medicine Physician in Columbia, MO
• Providers in Columbia, MO by specialty
• Neonatal-Perinatal Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.