PCRMC MEDICAL GROUP INC (NPI# 1447430574) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447430574 |
| Entity Type | Organization |
| Organization Name | PCRMC MEDICAL GROUP INC |
| Other Organization Name | PHELPS HEALTH MEDICAL GROUP WAYNESVILLE |
| Practice Address |
1000 Gw Lane Waynesville MO 65583-5401 |
| Mailing Address |
Po Box 579 Rolla MO 65402-0579 |
| Practice Telephone | 5737742715 |
| Practice Fax Number | 5737742792 |
| Mailing Telephone | 5734262182 |
| Mailing Fax Number | 5734265341 |
| Enumeration Date | 2007-11-06 |
| Last Update Date | 2019-01-17 |
| Authorized Official Name | JANA M COOK (VP, CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 5734587916 |
| Is Organization Subpart | Y |
| Parent Organization Name | PCRMC MEDICAL GROUP, INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208000000X | Pediatrics | 2007024375 | MO | Allopathic & Osteopathic Physicians |
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
MO | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 596499509 | 05 |
| Other Name | Type Code |
|---|---|
| Phelps Health Medical Group Waynesville | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093012890 | Pcrmc Medical Group Inc | Specialist | 1050 W 10th St, Ste 420, Rolla, MO 65401-2905 | 2011-02-15 |
| 1942491212 | Pcrmc Medical Group Inc | Otolaryngology | 1501 E 10th St, Suite B, Rolla, MO 65401-3696 | 2007-08-05 |
| Street Address |
1000 GW LANE |
| City | WAYNESVILLE |
| State | MO |
| Zip Code | 65583-5401 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972133460 | Fnp4jc, LLC | Family Medicine | 215 North Street, Waynesville, MO 65583 | 2020-01-23 |
| 1134770464 | Patricia Harper | Technician | 25455 Hwy W, Waynesville, MO 65583 | 2019-09-27 |
| 1619430519 | Charles L Quinn | Counselor | Hope Connections LLC 704 Historic Rte. 66w Suite 101, Waynesville, MO 65583 | 2019-04-09 |
| 1801340609 | Nicole Marie Decher | Social Worker | 704 Historic 66 W # 207, Waynesville, MO 65583 | 2016-08-09 |
| 1780952945 | Joseph Benton Isaac | Dentist | 1400 State Rd F, Reznicek Dental Group LLC, Waynesville, MO 65583 | 2011-12-02 |
| 1326325192 | Paul Duane Reznicek | Dentist | 1400 State Rt F, Waynesville, MO 65583 | 2011-11-08 |
| 1629366182 | Bletel Residential Homes | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 18844 Ladera Ln, Waynesville, MO 65583 | 2011-07-19 |
| 1720218126 | Pulaski County Board for The Handicapped | Case Management | 301 Historic Route 66 East, Waynesville, MO 65583 | 2009-07-20 |
| 1447436001 | Joseph Garold Moody | Counselor | 1000 Hospital Road., Piney Ridge Center, Waynesville, MO 65583 | 2008-01-14 |
| 1841404746 | Valencia Sivells | Counselor | 411 Historic Rte 66 West, Waynesville, MO 65583 | 2007-05-09 |
| Find all providers in zip 65583 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
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| 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 |
| Find all providers with the same taxonomy | ||||
| City | WAYNESVILLE |
| Zip Code | 65583 |
Please comment or provide details below to improve the information on PCRMC MEDICAL GROUP INC.
| 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.