NPIMap

Organization Active NPI

Ozarks Medical Center

Doing business as Ozarks Healthcare Orthopedics and Spine

  • Orthopaedic Surgery Physician
  • West Plains, MO
National Provider Identifier
1922397124
Registry record updated Nov 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
OZARKS MEDICAL CENTER
Doing business as
Ozarks Healthcare Orthopedics and Spine
Practice address
1210 N Kentucky Ave
West Plains, MO 65775-2030
Phone
(417) 256-1745
NPI assigned
Mar 29, 2011
Last updated
Nov 13, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2020

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

Authorized official

Name
Thomas W Keller
Title
President and Ceo
Phone
(417) 256-9111

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207X00000X Primary

Addresses

Primary practice location

1210 N Kentucky Ave
West Plains, MO 65775-2030

Mailing address

1210 N Kentucky Ave
West Plains, MO 65775-2030
Phone (417) 256-1745

Other names 1

  • Ozarks Healthcare Orthopedics and Spine Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040209001035 MO Part B Supplier - Clinic/Group Practice 3870491863 Receives reassigned benefits from 353 practitioners
28 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: West Plains, MO; Winona, MO; Willow Springs, MO; Gainesville, MO; Houston, MO; Mountain Grove, MO; Mountain View, MO; Thayer, MO

Other NPIs on the same Medicare enrollment 28

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

View all 28

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1301356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605225600000",
    "number": "1922397124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1210 N KENTUCKY AVE",
            "city": "WEST PLAINS",
            "state": "MO",
            "postal_code": "657752030",
            "telephone_number": "417-256-1745",
            "fax_number": "417-256-1746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210 N KENTUCKY AVE",
            "city": "WEST PLAINS",
            "state": "MO",
            "postal_code": "657752030",
            "telephone_number": "417-256-1745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OZARKS MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-29",
        "last_updated": "2020-11-13",
        "certification_date": "2020-11-13",
        "status": "A",
        "authorized_official_last_name": "KELLER",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "417-256-9111"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ozarks Healthcare Orthopedics and Spine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in West Plains, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2020; 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.