Farmington Clinic Company LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

FARMINGTON CLINIC COMPANY LLC

Doing business as

Maple Valley Primary Care

Practice address

751 Maple Valley Dr
Farmington, MO 63640-1944

Phone

(573) 756-1800

Fax

(573) 756-4476

NPI assigned

Sep 22, 2006

Last updated

Jul 21, 2022By the provider in NPPES

Organization subpart

Yes

Parent organization

FARMINGTON CLINIC COMPANY LLCAs reported in NPPES

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

Authorized official

Name

Michael Portacci

Title

President

Phone

(615) 465-7029

Specialties & licenses 1

Addresses

Other names 1

• Maple Valley Primary Care Doing business as

Part of

Farmington Clinic Company L

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1962501098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 504354",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631500001",
            "telephone_number": "573-756-1800",
            "fax_number": "573-756-4476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "751 MAPLE VALLEY DR",
            "city": "FARMINGTON",
            "state": "MO",
            "postal_code": "636401944",
            "telephone_number": "573-756-1800",
            "fax_number": "573-756-4476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FARMINGTON CLINIC COMPANY LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FARMINGTON CLINIC COMPANY LLC",
        "enumeration_date": "2006-09-22",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "PORTACCI",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "615-465-7029"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "MO",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Maple Valley Primary Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Farmington Ear, Nose, and Throat, LLC
• Farmington Emergency Group LLC
• Farmington Hand and Physical Therapy

• Family Medicine Physician in Farmington, MO
• Providers in Farmington, MO by specialty
• Family Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.