Professional Urgent Care LLC

Primary specialty

Urgent Care Clinic/CenterTaxonomy code 261QU0200X

License

20000152478 Issued in MO

Legal business name

PROFESSIONAL URGENT CARE LLC

Practice address

6055 N Main Street Rd
Webb City, MO 64870-7219

Phone

(620) 762-3809

Fax

(620) 674-3808

NPI assigned

Apr 8, 2014

Last updated

Oct 3, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Elesha Brooke Draeger, APRN

Title

Aprn

Phone

(620) 762-3809

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Forever Young

  • Clinic/Center
  • Webb City, MO
  • NPI 1619333481
  NPPES parent name

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

{
    "created_epoch": "1396915200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412294400000",
    "number": "1922427806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6031 N MAIN STREET RD # 395",
            "city": "WEBB CITY",
            "state": "MO",
            "postal_code": "648707219",
            "telephone_number": "417-206-0900",
            "fax_number": "417-206-0907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6055 N MAIN STREET RD",
            "city": "WEBB CITY",
            "state": "MO",
            "postal_code": "648707219",
            "telephone_number": "620-762-3809",
            "fax_number": "620-674-3808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL URGENT CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-08",
        "last_updated": "2014-10-03",
        "status": "A",
        "authorized_official_last_name": "DRAEGER",
        "authorized_official_first_name": "ELESHA",
        "authorized_official_middle_name": "BROOKE",
        "authorized_official_title_or_position": "APRN",
        "authorized_official_telephone_number": "620-762-3809",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "MO",
            "license": "20000152478",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200354220C",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "427487707",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary Ella Parker, MS NCC CCMHC LPC
• Rajendrakumar I Patel, M.D.
• Gretchen W Pearce, D.O.
• Monica Elizabeth Pelham, M.S., CF-SLP
• Ramona Perkins, M.A. CCC-SLP
• Joshua James Reed, PT, DPT
• William Edward Rice, DMD
• Carrie Roberts
• Alison M Rogers, MPT, CSMT
• RPCS, Inc (Price Cutter Pharmacy)

• Urgent Care Clinic/Center in Webb City, MO
• Providers in Webb City, MO by specialty
• Urgent Care Clinic/Center in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 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.