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General NPI Number Information
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NPI Number | 1497886451
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Entity Type | Organization
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Legal Business Name | MERCY CLINIC SPRINGFIELD COMMUNITIES
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Dates
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Enumeration Date | 03/08/2007
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Last Update Date | 10/14/2025
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Provider Practice Location Address
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Address Line | 404 W ROLLA RD
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City | SALEM
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State | MO
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Zip | 65560
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Country | US
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Telephone | 573-729-6225
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Fax | 573-729-7258
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Provider Business Mailing Address
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Address Line | 404 W ROLLA RD
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City | SALEM
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State | MO
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Zip | 65560-1233
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Country | US
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Telephone | 417-820-7133
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Fax | 417-820-0586
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Authorized Official
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Title or Position | CFO
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Name | WILLIAM J ROBERTS
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Credential |
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Telephone | 417-820-7363
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 113166
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 054413
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License Number State | MO
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Taxonomy #3
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State | MO
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