NPIMap

Organization Active NPI

St Johns Clinic Inc

Doing business as SJC-Family Medicine-South Creek

  • Durable Medical Equipment & Medical Supplies
  • Springfield, MO
National Provider Identifier
1962609446
Registry record updated Jun 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
ST JOHNS CLINIC INC
Doing business as
SJC-Family Medicine-South Creek
Practice address
2711 S Meadowbrook Ave
Springfield, MO 65807-5924
Phone
(417) 887-0081
Fax
(417) 227-1412
NPI assigned
Jun 28, 2007
Last updated
Jun 30, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2008

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

Authorized official

Name
Donn E. Sorensen
Title
Senior Vice President
Phone
(417) 829-4264

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X MO Primary

Addresses

Primary practice location

2711 S Meadowbrook Ave
Springfield, MO 65807-5924

Mailing address

PO Box 2580
Springfield, MO 65801-2580
Phone (417) 829-4620

Other names 1

  • SJC-Family Medicine-South Creek Doing business as

National Provider Directory

National Provider Directory
Tax ID family
SPFD CL Cancer and Hema55 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 14

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 14

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1182988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214784000000",
    "number": "1962609446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2580",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658012580",
            "telephone_number": "417-829-4620",
            "fax_number": "417-829-4316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2711 S MEADOWBROOK AVE",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658075924",
            "telephone_number": "417-887-0081",
            "fax_number": "417-227-1412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST JOHNS CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-28",
        "last_updated": "2008-06-30",
        "status": "A",
        "authorized_official_last_name": "SORENSEN",
        "authorized_official_first_name": "DONN",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "SENIOR VICE PRESIDENT",
        "authorized_official_telephone_number": "417-829-4264"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MO",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SJC-Family Medicine-South Creek",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Springfield, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2008; 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.