NPIMap

Organization Active NPI

South Central Missouri Community Health Center

  • Family Medicine Physician
  • Newburg, MO
National Provider Identifier
1982130118
Registry record updated May 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SOUTH CENTRAL MISSOURI COMMUNITY HEALTH CENTER
Practice address
701 Wolfpride Dr
Newburg, MO 65550-7824
Phone
(573) 426-6712
Fax
(573) 426-6735
NPI assigned
May 9, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 9, 2017

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

Authorized official

Name
Kelly Miller
Title
Ceo
Phone
(573) 426-6712

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

701 Wolfpride Dr
Newburg, MO 65550-7824

Mailing address

1081 E 18TH St
Rolla, MO 65401-2448
Phone (573) 426-6712

Other identifiers 1

IdentifierTypeStateIssuer
1164669172MedicaidMO

Other names 1

  • Your Community Health Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
South Central Missouri Community Health Center13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

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

NPI Registry JSON

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

{
    "created_epoch": "1494288000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1494288000000",
    "number": "1982130118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1081 E 18TH ST",
            "city": "ROLLA",
            "state": "MO",
            "postal_code": "654012448",
            "telephone_number": "573-426-6712",
            "fax_number": "573-426-6735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 WOLFPRIDE DR",
            "city": "NEWBURG",
            "state": "MO",
            "postal_code": "655507824",
            "telephone_number": "573-426-6712",
            "fax_number": "573-426-6735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH CENTRAL MISSOURI COMMUNITY HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-09",
        "last_updated": "2017-05-09",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "573-426-6712"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1164669172",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Your Community Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Newburg, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2017; 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.