NPIMap

Organization Active NPI

Missouri Baptist Hospital of Sullivan

Doing business as Sullivan Medical Office

  • Multi-Specialty Clinic/Center
  • Sullivan, MO
National Provider Identifier
1851841332
Registry record updated Mar 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
MISSOURI BAPTIST HOSPITAL OF SULLIVAN
Doing business as
Sullivan Medical Office
Practice address
965 Mattox Dr
Sullivan, MO 63080-2365
Phone
(573) 860-6000
NPI assigned
Oct 10, 2016
Last updated
Mar 23, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2021

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

Authorized official

Name
Tony L Schwarm
Title
President
Phone
(573) 468-4186

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

965 Mattox Dr
Sullivan, MO 63080-2365

Mailing address

751 Sappington Bridge Rd
Administration
Sullivan, MO 63080-2354
Phone (573) 860-6000

Other names 1

  • Sullivan Medical Office Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

National Provider Directory

National Provider Directory
Tax ID family
Armela R Agasino MD8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1476057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616457600000",
    "number": "1851841332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "751 SAPPINGTON BRIDGE RD",
            "address_2": "ADMINISTRATION",
            "city": "SULLIVAN",
            "state": "MO",
            "postal_code": "630802354",
            "telephone_number": "573-860-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "965 MATTOX DR",
            "city": "SULLIVAN",
            "state": "MO",
            "postal_code": "630802365",
            "telephone_number": "573-860-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSOURI BAPTIST HOSPITAL OF SULLIVAN",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-10",
        "last_updated": "2021-03-23",
        "certification_date": "2021-03-23",
        "status": "A",
        "authorized_official_last_name": "SCHWARM",
        "authorized_official_first_name": "TONY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "573-468-4186"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "965 Mattox Dr",
            "city": "Sullivan",
            "state": "MO",
            "country_code": "US",
            "postal_code": "630802365",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Sullivan Medical Office",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Sullivan Medical Office",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sullivan, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2021; 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.