NPIMap

Organization Active NPI

Midwest Health Group Convenient Care, LLC

  • Non-Pharmacy Dispensing Site
  • Farmington, MO
National Provider Identifier
1982057501
Registry record updated Jul 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
Legal business name
MIDWEST HEALTH GROUP CONVENIENT CARE, LLC
Practice address
550 Maple Valley Dr
Farmington, MO 63640-1981
Phone
(573) 454-2466
Fax
(573) 454-2544
NPI assigned
Jul 19, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2016

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

Authorized official

Name
Mrs. Mary Elizabeth Chandler, FNP-C
Title
Manager
Phone
(573) 358-1700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Pharmacy Dispensing Site 332900000X Primary

Addresses

Primary practice location

550 Maple Valley Dr
Farmington, MO 63640-1981

Mailing address

55 Nesbit Dr
Bonne Terre, MO 63628-1353
Phone (573) 358-1700

Other names 1

  • Midwest Convenient Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Midwest Convenient Care3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

550 Maple Valley Dr
Farmington, MO 63640
Phone (573) 454-2466

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1468886400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1468886400000",
    "number": "1982057501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 NESBIT DR",
            "city": "BONNE TERRE",
            "state": "MO",
            "postal_code": "636281353",
            "telephone_number": "573-358-1700",
            "fax_number": "573-358-1702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 MAPLE VALLEY DR",
            "city": "FARMINGTON",
            "state": "MO",
            "postal_code": "636401981",
            "telephone_number": "573-454-2466",
            "fax_number": "573-454-2544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWEST HEALTH GROUP CONVENIENT CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-19",
        "last_updated": "2016-07-19",
        "status": "A",
        "authorized_official_last_name": "CHANDLER",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "ELIZABETH",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "573-358-1700",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "FNP-C"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Midwest Convenient Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Farmington, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2016; 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.