LIBERTY MEDICAL CENTER PC NPI 1679777908

NPI Information

  • NPI: 1679777908
  • Provider Name: LIBERTY MEDICAL CENTER PC
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Organization
  • Address: 1504 NE 96TH ST
    LIBERTY, MO
    ZIP 64068
  • Phone: (816) 415-2233

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NPI Details

LIBERTY MEDICAL CENTER PC is a family medicine in Liberty, 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. LIBERTY MEDICAL CENTER PC NPI is 1679777908. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1504 NE 96TH ST
LIBERTY, MO
ZIP 64068-348
Phone: (816) 415-2233
Fax: (816) 415-2218

The provider's authorized official is Rodney James Malisos .
The authorized official title is President and has the following contact phone number (816) 415-2233.

The enumeration date for this NPI number is 6/12/2007 and was last updated on 9/10/2013.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily Medicine2000146367MISSOURIYes

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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1H46335MEDICARE UPINMISSOURI
2P460000MEDICARE ID-TYPE UNSPECIFIEDMISSOURIMEDICARE GROUP ID #
3205388101MEDICAIDMISSOURI

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: 11/21/2025

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