Rolla Urgent Care LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

2002009086

Legal business name

ROLLA URGENT CARE LLC

Practice address

1060 S Bishop Ave
Rolla, MO 65401-4411

Phone

(573) 426-5900

Fax

(573) 426-4466

NPI assigned

Apr 17, 2007

Organization subpart

Yes

Parent organization

ROLLA URGENT CARE LLCAs reported in NPPES

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

Authorized official

Name

Mr. Oluyomi O Olusanya, MD

Title

Owner/del. Official

Phone

(573) 426-5900

Specialties & licenses 3

Addresses

Other names 1

• Rolla Urgent Care Rural Health Clinic Other name

Part of

Rolla Urgent Care LLC

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Rolla Urgent Care, LLC

  • Rural Health Clinic/Center
  • Rolla, MO
  • NPI 1326099417
  NPPES parent name

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1505347200000",
    "number": "1881819464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 817",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637020817",
            "telephone_number": "314-989-0300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1060 S BISHOP AVE",
            "city": "ROLLA",
            "state": "MO",
            "postal_code": "654014411",
            "telephone_number": "573-426-5900",
            "fax_number": "573-426-4466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROLLA URGENT CARE LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ROLLA URGENT CARE LLC",
        "enumeration_date": "2007-04-17",
        "last_updated": "2017-09-14",
        "status": "A",
        "authorized_official_last_name": "OLUSANYA",
        "authorized_official_first_name": "OLUYOMI",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "OWNER/DEL. OFFICIAL",
        "authorized_official_telephone_number": "573-426-5900",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": "2002009086",
            "primary": true
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": "124268",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rolla Urgent Care Rural Health Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Internal Medicine Physician in Rolla, MO
• Providers in Rolla, MO by specialty
• Internal Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2017; 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.