MERCY CLINIC SPRINGFIELD COMMUNITIES (NPI# 1922137645) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922137645 |
| Entity Type | Organization |
| Organization Name | MERCY CLINIC SPRINGFIELD COMMUNITIES |
| Other Organization Name | MERCY CLINIC PEDIATRICS-ROLLA |
| Practice Address |
1605 Martin Springs Dr Suite 250 Rolla MO 65401 |
| Mailing Address |
645 Maryville Centre Dr Fl 3 Saint Louis MO 63141-5855 |
| Practice Telephone | 5734586363 |
| Practice Fax Number | 5734586765 |
| Mailing Telephone | 4178207133 |
| Mailing Fax Number | 4178200586 |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2018-12-04 |
| Authorized Official Name | DR. ROBERT CAVAGNOL (CHIEF PHYSICIAN OFFICER) |
| Authorized Official Telephone | 4178202705 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
146525 | MO | Physician Assistants & Advanced Practice Nursing Providers |
| N | 208000000X | Pediatrics | 108228 | MO | Allopathic & Osteopathic Physicians |
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
MO | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 597380708 | 05 |
| Other Name | Type Code |
|---|---|
| Mercy Clinic Pediatrics-Rolla | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659785657 | Mercy Clinic Springfield Communities | Radiology | 11701 Bee Cave Pkwy, Suite 213, Bee Cave, TX 78738-6466 | 2014-06-17 |
| 1770612590 | Mercy Clinic Springfield Communities | Nurse Practitioner | 120 Hospital Dr Ste 350, Lebanon, MO 65536-9253 | 2007-03-05 |
| 1952437675 | Mercy Clinic Springfield Communities | Family Medicine | 18598 Business 13, Branson West, MO 65737 | 2007-02-26 |
| 1811065477 | Mercy Clinic Springfield Communities | Family Medicine | 9138 O'banion St, Birch Tree, MO 65438 | 2006-12-01 |
| 1538195508 | Mercy Clinic Springfield Communities | Family Medicine | 1 Park Dr, Suite C, Holiday Island, AR 72631-9216 | 2006-06-23 |
| 1053347807 | Mercy Clinic Springfield Communities | Family Medicine | 100 Medical Cir, Green Forest, AR 72638-3802 | 2006-06-23 |
| 1740226091 | Mercy Clinic Springfield Communities | Family Medicine | 207 Carter St, Berryville, AR 72616-4303 | 2006-06-22 |
| 1881636884 | Mercy Clinic Springfield Communities | Psychologist | 1312 E Lark St, Springfield, MO 65804-7351 | 2006-06-12 |
| 1124069877 | Mercy Clinic Springfield Communities | Obstetrics & Gynecology | 613 Orchard Dr, Berryville, AR 72616-5013 | 2006-06-10 |
| 1245277631 | Mercy Clinic Springfield Communities | Internal Medicine | 3231 S National Ave Ste 220, Springfield, MO 65807 | 2006-06-02 |
| Street Address |
1605 MARTIN SPRINGS DR SUITE 250 |
| City | ROLLA |
| State | MO |
| Zip Code | 65401 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124024468 | William S Anast | Anesthesiology | 1605 Martin Springs Dr, Rolla, MO 65401-2982 | 2005-06-22 |
| 1477092906 | Amanda Creamer | Nurse Practitioner | 1605 Martin Springs Dr, Ste 210, Rolla, MO 65401-2982 | 2017-02-16 |
| 1851839716 | Richard Siska Sr. | Radiologic Technologist | 1605 Martin Springs Dr, Ste 110, Rolla, MO 65401-2982 | 2017-02-10 |
| 1922457712 | Madhura G Joag | Internal Medicine | 1605 Martin Springs Dr, Rolla, MO 65401-2982 | 2016-06-13 |
| 1497115497 | Di'ara Woods | Physician Assistant | 1605 Martin Springs Dr, Ste 230, Rolla, MO 65401-2982 | 2016-03-03 |
| 1104260090 | Omofolarin Babatunji Fasuyi | Family Medicine | 1605 Martin Springs Dr, Suite 210, Rolla, MO 65401-2982 | 2013-04-22 |
| 1790037950 | Lisa A Cunningham | Nurse Practitioner | 1605 Martin Springs Dr, Ste 250, Rolla, MO 65401-2931 | 2012-10-11 |
| 1043562358 | Mercy Hospital Lebanon | Clinic/Center | 1605 Martin Springs Dr, Rolla, MO 65401-2931 | 2012-10-10 |
| 1801148499 | Mercy Hospital Lebanon | Radiology | 1605 Martin Springs Dr, Rolla, MO 65401-2982 | 2012-10-08 |
| 1265787741 | Cheri Berti | Pharmacist | 1605 Martin Springs Dr, Suite 220, Rolla, MO 65401-2931 | 2012-07-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639645591 | Samantha Jo Mitchell | Pharmacist | 1375 E 10th St Suite B, Rolla, MO 65401 | 2018-10-18 |
| 1427567726 | Gerry Wade Funkhouser Jr. | Counselor | 103 W 10th St, Rolla, MO 65401 | 2017-09-29 |
| 1366967960 | Shana Hintz Wisniewski | Social Worker | 1000 W. 10th St., Rolla, MO 65401 | 2017-08-04 |
| 1174066559 | Tabitha Hundt | Counselor | 1011 Cypress Dr, Rolla, MO 65401 | 2016-12-02 |
| 1841742855 | Alpha Assisted Living LLC | Assisted Living Facility | 13450 Cr 7040, 803 E 12th St, Rolla, MO 65401 | 2016-10-26 |
| 1275916884 | Elizabeth Zersen | Occupational Therapist | 2053 Vienna Rd, Rolla, MO 65401 | 2015-06-30 |
| 1386047025 | Becky L Witham | Nurse Practitioner | 1060 W 10th Street, Rolla, MO 65401 | 2014-10-08 |
| 1114326121 | Summer Adey | Licensed Practical Nurse | 13750 State Route F, Rolla, MO 65401 | 2014-08-14 |
| 1518303296 | Leaetta Mildred Gardner | Nursing Facility/Intermediate Care Facility | 13450 County Road 7040, Rolla, MO 65401 | 2013-05-21 |
| 1316282064 | Susan Peitz Gruener | Occupational Therapy Assistant | 1800 White Column Road, Rolla, MO 65401 | 2012-12-06 |
| Find all providers in zip 65401 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326416025 | Morton County Hospital | Clinic/Center | 415 Washington, Rolla, KS 67954 | 2015-09-11 |
| 1700064599 | Rolla Eye Clinic | Clinic/Center | 118 3rd St. Ne, Rolla, ND 58367-1170 | 2008-02-05 |
| 1366066037 | Pcrmc Medical Group, Inc | Clinic/Center | 1050 W 10th St, Rolla, MO 65401-2905 | 2020-05-29 |
| 1457691305 | Presentation Medical Center | Clinic/Center | 213 2nd Ave Ne, Rolla, ND 58367-7153 | 2013-02-28 |
| 1881819464 | Rolla Urgent Care LLC | Clinic/Center | 1060 S Bishop Ave, Rolla, MO 65401-4411 | 2007-04-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871102137 | Washington County Memorial Hospital | Clinic/Center | 14206 Hwy C, Belgrade, MO 63622 | 2020-07-23 |
| 1891325072 | Scotland County Memorial Hospital | Clinic/Center | 55682 State Highway 6 Ste A, Edina, MO 63537-4268 | 2020-01-16 |
| 1639736457 | Southeast Health Center of Stoddard County LLC | Clinic/Center | 800 Us Highway 61, New Madrid, MO 63869-1106 | 2019-05-28 |
| 1134633456 | Pike County Memorial Hospital | Clinic/Center | 1420 S Business 61 Unit Fde, Bowling Green, MO 63334-5230 | 2017-11-22 |
| 1720505894 | Perry County Health System | Clinic/Center | 210 Hospital Ln Ste 202, Perryville, MO 63775-4200 | 2017-08-29 |
| 1427572007 | Missouri Delta Medical Center | Clinic/Center | 209 W Yoakum Ave, Chaffee, MO 63740-1138 | 2017-07-26 |
| 1790213676 | Jackson Primary Care LLC | Clinic/Center | 2685 E Main St Ste A, Jackson, MO 63755-2474 | 2017-05-23 |
| 1972050581 | Sgoh Acquisition, Inc. | Clinic/Center | 912b State Highway 59, Goodman, MO 64843-8252 | 2016-09-01 |
| 1144605312 | Nevada City Hospital | Clinic/Center | 627 S Ash St Ste B, Nevada, MO 64772 | 2015-07-29 |
| 1669856829 | Ssm Regional Health Services | Clinic/Center | 2511 W Edgewood Dr Ste F, Jefferson City, MO 65109-5869 | 2015-07-16 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.