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MERCY CLINIC JOPLIN LLC NPI 1215264817


NPI Information

NPI: 1215264817
Provider Name: MERCY CLINIC JOPLIN LLC
Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 26D0978869

Address:
100 MERCY WAY
JOPLIN, MO
ZIP 64804
Phone: (417) 556-2727
Get Directions

MERCY CLINIC JOPLIN LLC is a family medicine in Joplin, MO. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. MERCY CLINIC JOPLIN LLC NPI is 1215264817. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

100 MERCY WAY
JOPLIN, MO
ZIP 64804-524
Phone: (417) 556-2727

The provider's authorized official is Tracy A Godfrey .
The authorized official title is President and has the following contact phone number (417) 556-8962.

The CLIA number assigned to this NPI record is 26D0978869 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/3/2009 and was last updated on 4/20/2015.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207R00000XInternal MedicineMISSOURINo
2207RC0000XInternal MedicineCardiovascular DiseaseMISSOURINo
3207V00000XObstetrics & GynecologyMISSOURINo
4208600000XSurgeryMISSOURINo
5207Q00000XFamily MedicineMISSOURIYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1MA3446MEDICARE PINMISSOURI
2200639810AMEDICAIDKANSAS
3MA2082MEDICARE PINMISSOURI
4181336002MEDICAIDARKANSAS
5200274980BMEDICAIDOKLAHOMA
6MA2083MEDICARE PINMISSOURI
71215264817MEDICAIDMISSOURI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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