Organization Active NPI

Medstop One Diagnostics LLC

  • General Practice Physician
  • Cape Girardeau, MO
National Provider Identifier
1871893743
Registry record updated Oct 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
MEDSTOP ONE DIAGNOSTICS LLC
Practice address
3065 William St
Ste 211
Cape Girardeau, MO 63703-6393
Phone
(573) 335-4100
Fax
(573) 339-7887
NPI assigned
Oct 26, 2010
Last updated
Oct 7, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2020

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

Authorized official

Name
Stacey L Gallaher
Title
Billing
Phone
(573) 335-1779

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

3065 William St
Ste 211
Cape Girardeau, MO 63703-6393

Mailing address

PO Box 1623
Cape Girardeau, MO 63702-1623
Phone (573) 335-1779

National Provider Directory

National Provider Directory

Locations

3065 William St
Ste 211
Cpe Girardeau, MO 63703
Phone (573) 335-1779

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1288051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602028800000",
    "number": "1871893743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1623",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637021623",
            "telephone_number": "573-335-1779",
            "fax_number": "573-335-1772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3065 WILLIAM ST",
            "address_2": "STE 211",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637036393",
            "telephone_number": "573-335-4100",
            "fax_number": "573-339-7887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDSTOP ONE DIAGNOSTICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-26",
        "last_updated": "2020-10-07",
        "certification_date": "2020-10-07",
        "status": "A",
        "authorized_official_last_name": "GALLAHER",
        "authorized_official_first_name": "STACEY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "BILLING",
        "authorized_official_telephone_number": "573-335-1779"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Girardeau, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 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.