NPIMap

Organization Active NPI

Skaggs Community Hosptial Association

Doing business as Tri-Lakes Internal Medicine & Rheumatology

  • Rheumatology Physician
  • Branson, MO
National Provider Identifier
1871522904
Registry record updated Feb 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
5248 Issued in MO
Legal business name
SKAGGS COMMUNITY HOSPTIAL ASSOCIATION
Doing business as
Tri-Lakes Internal Medicine & Rheumatology
Practice address
101 Skaggs Rd
Medical Plaza 1 Ste 403
Branson, MO 65616
Phone
(417) 348-8105
Fax
(417) 348-8107
NPI assigned
Jul 1, 2006
Last updated
Feb 28, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2008

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

Authorized official

Name
Stephen M Erixon
Title
Ceo
Phone
(417) 335-7350

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X 5248 MO Primary

Addresses

Primary practice location

101 Skaggs Rd
Medical Plaza 1 Ste 403
Branson, MO 65616

Mailing address

101 Skaggs Rd
Medical Plaza 1 Ste 403
Branson, MO 65616
Phone (417) 348-8105

Other identifiers 1

IdentifierTypeStateIssuer
CI2096OtherRAILROAD MEDICARE

Other names 1

  • Tri-Lakes Internal Medicine & Rheumatology Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1151712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204156800000",
    "number": "1871522904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 SKAGGS RD",
            "address_2": "MEDICAL PLAZA 1 STE 403",
            "city": "BRANSON",
            "state": "MO",
            "postal_code": "65616",
            "telephone_number": "417-348-8105",
            "fax_number": "417-348-8107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 SKAGGS RD",
            "address_2": "MEDICAL PLAZA 1 STE 403",
            "city": "BRANSON",
            "state": "MO",
            "postal_code": "65616",
            "telephone_number": "417-348-8105",
            "fax_number": "417-348-8107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SKAGGS COMMUNITY HOSPTIAL ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-01",
        "last_updated": "2008-02-28",
        "status": "A",
        "authorized_official_last_name": "ERIXON",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "417-335-7350"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "MO",
            "license": "5248",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CI2096",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tri-Lakes Internal Medicine & Rheumatology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Branson, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 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.