Ozarks Medical Center
Organization Active NPI Orthopaedic Surgery Physician · West Plains, MO
NPI 1922397124 · NPPES record last updated Nov 13, 2020
Key facts
- NPI
- 1922397124
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Orthopaedic Surgery Physician 207X00000X
- Legal business name
- OZARKS MEDICAL CENTER
- Practice address
- 1210 N Kentucky Ave
West Plains, MO 65775-2030 - Phone
- (417) 256-1745
- NPI assigned
- Mar 29, 2011
- Organization subpart
- No
Authorized official
- Name
- Thomas W Keller
- Title
- President and Ceo
- Phone
- (417) 256-9111
Other NPIs on the same Medicare enrollment 28
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician |
207X00000X | Yes |
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 identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 193200000X | Medicaid | MO | |
| 187743002 | Medicaid | AR |
Other names
- Ozarks Healthcare Orthopedics and Spine
Other providers in West Plains, MO
- Ozarks Medical Center
- Ozarks Medical Center
- Ozarks Medical Center
- Ozarks Medical Center
- Ozarks Medical Center
- Ozarks Medical Center
- Ozarks Medical Center Dba Riverways Support Services
- Ozarks Neurosurgical Associates LLC
- Stacey Ozias
- Lacy N Ozimek
All providers in West Plains, MO · Orthopaedic Surgery Physician in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 13, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.