MERCY CLINIC FAMILY MEDICINE-SHELL KNOB
NPI 1104137876
Clinic/Center - Rural Health in Shell Knob, MO

Q: What is Mercy Clinic-Springfield Communities's NPI number?

The NPI number for Mercy Clinic-Springfield Communities is 1104137876. It was assigned to this organization in the NPPES registry on June 28, 2010. The provider is doing business as Mercy Clinic Family Medicine-Shell Knob.

Q: What is Mercy Clinic-Springfield Communities's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rural Health, with taxonomy code 261QR1300X.

Active since June 28, 2010CLIA 26D0701240 · Waiver

22361 OAK RIDGE DR, SHELL KNOB, MO 65747(417) 858-3731(417) 858-2562 Get Directions Write a Review

NPPES record last updated: April 28, 2015. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Mercy Clinic Family Medicine-shell Knob NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MERCY CLINIC FAMILY MEDICINE-SHELL KNOB (NPI 1104137876) is a healthcare organization registered as a rural health in Shell Knob, Missouri and active in the NPI registry since June 2010. The organization holds a CLIA Waiver certificate valid through May 3, 2027 and lists Stuart G. Stangeland, Senior Vice President, Coo, as its authorized official.

NPPES Registry Identity

NPI1104137876

Entity TypeOrganization

Primary Taxonomy261QR1300X

Legal Business NameMERCY CLINIC-SPRINGFIELD COMMUNITIES

Location Address22361 OAK RIDGE DRShell Knob, MO 65747-7822

Mailing AddressPo Box 505164Saint Louis, MO 63150-5164 · (417) 820-2000

Phone(417) 858-3731

Fax(417) 858-2562

Organization SubpartNo

Authorized OfficialStuart G. StangelandSenior Vice President, Coo · (417) 820-6556

Enumeration DateJune 28, 2010

Last NPPES UpdateApril 28, 2015

✔ NPI 1104137876 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Rural HealthAmbulatory Health Care Facilities

Taxonomy Code261QR1300X

22361 OAK RIDGE DR, Shell Knob, MO 65747

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Other Names 1

Doing Business AsMercy Clinic Family Medicine-shell Knob

Other Identifiers 2

Medicare OSCAR/certification793805MO

Other1104137876MO · Rural Health Medicaid

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 26D0701240

Mercy Clinic Family Medicine Shell Knob · Shell Knob, MO

Active · expires May 3, 2027

CLIA Number26D0701240

Laboratory TypeCommunity Clinic

Certificate Effective DateMay 4, 2025

Certificate Expiration DateMay 3, 2027

Laboratory DirectorDr. Fabian Oechsle

Laboratory Phone(417) 858-3731

Laboratory LocationMercy Clinic Family Medicine Shell Knob22361 Oak Ridge Drive, Shell Knob, MO 65747

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. PATRICK B. HARR M.D.

Family Medicine (Sports Medicine)