Healthcare Provider Details

I. General information

NPI: 1386017648
Provider Name (Legal Business Name): BIRTHCENTERED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/09/2015
Last Update Date: 07/26/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3840 SOUTH AVE
SPRINGFIELD MO
65807-5285
US

IV. Provider business mailing address

6006 N 13TH AVE
OZARK MO
65721-5771
US

V. Phone/Fax

Practice location:
  • Phone: 417-224-0802
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QB0400X
TaxonomyBirthing Clinic/Center
License Number0016-0
License Number StateMO

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: SARAH BARKLEY
Title or Position: ADMINISTRATOR
Credential:
Phone: 417-616-3114