NPIMap

Organization Active NPI

Lincoln County Memorial Hospital

  • Primary Care Clinic/Center
  • Troy, MO
National Provider Identifier
1902820012
Registry record updated Dec 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
LINCOLN COUNTY MEMORIAL HOSPITAL
Doing business as
Doctors Professional Clinic
Practice address
1165 E Cherry St
Troy, MO 63379-1520
Phone
(636) 528-7722
Fax
(636) 528-7744
NPI assigned
Jul 26, 2006
Organization subpart
Yes
Parent organization
LINCOLN COUNTY MEMORIAL HOSPITAL DBA LINCOLN COUNTY MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 18, 2014

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

Authorized official

Name
Mr. Patrick G Bira
Title
Chief Executive Officer
Phone
(636) 528-3326

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

1165 E Cherry St
Troy, MO 63379-1520

Mailing address

1165 E Cherry St
Troy, MO 63379-1520
Phone (636) 528-7722

Other identifiers 1

IdentifierTypeStateIssuer
242201705MedicaidMO

Other names 1

  • Doctors Professional Clinic Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Mercy Hospital Lincoln10 organizations share this tax ID, including this one
Part of
Troy Surgical Clinic

Other organizations with this tax ID 9

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": "1153872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1418860800000",
    "number": "1902820012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1165 E CHERRY ST",
            "city": "TROY",
            "state": "MO",
            "postal_code": "633791520",
            "telephone_number": "636-528-7722",
            "fax_number": "636-528-7744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1165 E CHERRY ST",
            "city": "TROY",
            "state": "MO",
            "postal_code": "633791520",
            "telephone_number": "636-528-7722",
            "fax_number": "636-528-7744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LINCOLN COUNTY MEMORIAL HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LINCOLN COUNTY MEMORIAL HOSPITAL DBA LINCOLN COUNTY MEDICAL CENTER",
        "enumeration_date": "2006-07-26",
        "last_updated": "2014-12-18",
        "status": "A",
        "authorized_official_last_name": "BIRA",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "636-528-3326",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "242201705",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Doctors Professional Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Troy, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2014; 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.