NPIMap

Organization Active NPI

Mercy Clinic Springfield Communities

Doing business as Mercy Clinic Family Medicine-Willow Springs

  • Rural Health Clinic/Center
  • Willow Springs, MO
National Provider Identifier
1972771657
Registry record updated Dec 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
MERCY CLINIC SPRINGFIELD COMMUNITIES
Doing business as
Mercy Clinic Family Medicine-Willow Springs
Practice address
1202 E Main St
Willow Springs, MO 65793
Phone
(417) 469-1820
Fax
(417) 469-5280
NPI assigned
Feb 14, 2008
Last updated
Dec 4, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2018

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

Authorized official

Name
Dr. Robert Cavagnol
Title
Chief Physician Officer
Phone
(417) 820-2705

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X MO Primary
Family Nurse Practitioner 363LF0000X 2013019442 MO
Family Medicine Physician 207Q00000X 2009010253 MO

Addresses

Primary practice location

1202 E Main St
Willow Springs, MO 65793

Mailing address

645 Maryville Centre Dr FL 3
Saint Louis, MO 63141-5855
Phone (417) 820-7133

Other identifiers 1

IdentifierTypeStateIssuer
1972771657OtherMORURAL HEALTH MEDICAID

Other names 1

  • Mercy Clinic Family Medicine-Willow Springs Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031218000354 MO Part B Supplier - Clinic/Group Practice 7416865845 Receives reassigned benefits from 1,639 practitioners
29 other NPIs on this enrollment

Other NPIs on the same Medicare enrollment 29

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

View all 29

National Provider Directory

National Provider Directory

Locations (25 of 87)

301 W Trimble Ave
Berryville, AR 72616
Phone (870) 423-3000

100 Medical Cir
Green Forest, AR 72638
Phone (870) 438-5216

721 E Highland St
Aurora, MO 65605
Phone (417) 308-2278

9138 Obanion St
Birch Tree, MO 65438
Phone (573) 292-3213

3817 S Springfield Ave
Ste 180
Bolivar, MO 65613
Phone (417) 820-5750

1065 State Highway 248
Branson, MO 65616
Phone (417) 332-3639

1065 State Highway 248
Ste 100
Branson, MO 65616
Phone (417) 334-7647

1940 State Hwy 165
Branson, MO 65616
Phone (417) 336-7575

448 State Highway 248
Ste 180
Branson, MO 65616
Phone (417) 820-2064

90 Gravel St
Cassville, MO 65625
Phone (417) 847-6000

151 Birch Rd
Hollister, MO 65672
Phone (417) 336-4355

290 Clift Ct
Hollister, MO 65672
Phone (417) 336-4355

3126 S Jackson Ave
Ste 105
Joplin, MO 64804
Phone (417) 820-0280

120 Hospital Dr
Ste 100
Lebanon, MO 65536
Phone (417) 533-6751

120 Hospital Dr
Ste 125
Lebanon, MO 65536
Phone (417) 533-6710

1234 Deadra Dr
Lebanon, MO 65536
Phone (417) 532-2675

1234 Deadra Dr
Slp Med
Lebanon, MO 65536
Phone (417) 532-2675

331 Hospital Dr
Ste B
Lebanon, MO 65536
Phone (417) 532-3495

341 Hospital Dr
Ste 100
Lebanon, MO 65536
Phone (417) 533-6545

515 Cowan Dr
Lebanon, MO 65536
Phone (417) 533-6545

315 E Cleveland Ave
Monett, MO 65708
Phone (417) 235-0196

1319 S Landrum St
Ste B
Mount Vernon, MO 65712
Phone (417) 466-2640

100 W US Highway 60
Ste 2
Mountain View, MO 65548
Phone (417) 934-2251

701 N McCroskey St
Nixa, MO 65714
Phone (417) 449-5920

940 W Mount Vernon St
Ste 100
Nixa, MO 65714
Phone (417) 724-5200

Practitioners & affiliated clinicians

Practitioners 1,943

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.

View all 1,943

NPI Registry JSON

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

{
    "created_epoch": "1202947200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1543881600000",
    "number": "1972771657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "645 MARYVILLE CENTRE DR FL 3",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631415855",
            "telephone_number": "417-820-7133",
            "fax_number": "417-820-0586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1202 E MAIN ST",
            "city": "WILLOW SPRINGS",
            "state": "MO",
            "postal_code": "65793",
            "telephone_number": "417-469-1820",
            "fax_number": "417-469-5280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY CLINIC SPRINGFIELD COMMUNITIES",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-14",
        "last_updated": "2018-12-04",
        "status": "A",
        "authorized_official_last_name": "CAVAGNOL",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "CHIEF PHYSICIAN OFFICER",
        "authorized_official_telephone_number": "417-820-2705",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "MO",
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2013019442",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2009010253",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RURAL HEALTH MEDICAID",
            "identifier": "1972771657",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mercy Clinic Family Medicine-Willow Springs",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mercy Clinic Family Medicine-Willow Springs",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Willow Springs, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2018; 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.