Ozark Rural Healthcare LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

OZARK RURAL HEALTHCARE LLC

Practice address

3001 Warrior LN
Poplar Bluff, MO 63901-8685

Phone

(312) 953-5636

NPI assigned

Oct 10, 2022

Last updated

Oct 10, 2022By 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

Sarfaraz Abdeali Jasdanwala, MDNPI 1851646665

Title

Owner/Ceo

Phone

(312) 953-5636

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

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

• Ozark Rural Healthcare LLC

  • Internal Medicine Physician
  • Kansas City, MO
  • NPI 1851026439

  O20221005000237

  Same enrollment

Practitioners 1

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.

• Sarfaraz A Jasdanwala, MD

  • Internal Medicine Physician
  • Grand Rapids, MI
  • NPI 1851646665
  NPD Authorized official

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

{
    "created_epoch": "1665360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665360000000",
    "number": "1871218099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17781 HORNBEAN DR",
            "city": "WILDWOOD",
            "state": "MO",
            "postal_code": "630054229",
            "telephone_number": "312-953-5636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 WARRIOR LN",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639018685",
            "telephone_number": "312-953-5636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OZARK RURAL HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-10",
        "last_updated": "2022-10-10",
        "certification_date": "2022-10-10",
        "status": "A",
        "authorized_official_last_name": "JASDANWALA",
        "authorized_official_first_name": "SARFARAZ",
        "authorized_official_middle_name": "ABDEALI",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "312-953-5636",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ozark Physical Medicine Center for Operations Ozark Plaza and Medical (Ozark Home Healthcare)
• Ozark Physical Medicine Center for Operations Ozark Plaza and Medical (Ozark Home Medical Equipment)
• Ozark Physical Therapy
• Ozark Physical Therapy LLP
• Ozark Physical Therapy, LLP
• Ozark Specialty Pharmacy and Home Infusion, LLC
• Ozark Specialty Pharmacy and Home Infusion, LLC (Ozark Pharmacy, LTC)
• Ozark Specialty Pharmacy and Home Infusion, LLC (Ozark Pharmacy)
• Teri Lynn Page, O.D.
• Silvia Pagoada Vallecillo, M.D.

• Clinic/Center in Poplar Bluff, MO
• Providers in Poplar Bluff, MO by specialty
• Clinic/Center in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.