PHELPS HEALTH MEDICAL GROUP VIENNA
NPI 1114235041
Clinic/Center - Rural Health in Vienna, MO

NPI Status: Active since September 14, 2010

Contact Information

606 HIGHWAY 63 S
VIENNA, MO
ZIP 65582
Phone: (573) 422-3636
Fax: (573) 422-3434

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  • Organization
  • Clinic/Center
  • Rural Health
  • Accepts Insurance
  • CLIA Number: 26D1052781
  • CLIA Cert. Type: Rural Health Clinic
  • CLIA Exp. Date: 12-31-2027

About PHELPS HEALTH MEDICAL GROUP VIENNA

This page provides the complete NPI Profile along with additional information for Phelps Health Medical Group Vienna, a primary care provider established in Vienna, Missouri operating as a Clinic/center, focusing in rural health . The healthcare provider is registered in the NPI registry with number 1114235041 assigned on September 2010. The practitioner's primary taxonomy code is 261QR1300X with license number 2007024375 (MO). The provider is registered as an organization and their NPI record was last updated 7 years ago. The provider's is doing business as Phelps Health Medical Group Vienna. The authorized official of this NPI record is Jana M Cook (Vp, Chief Financial Officer)

NPI
1114235041
Provider Legal Name
PCRMC MEDICAL GROUP, INC
Other Organization Name
PHELPS HEALTH MEDICAL GROUP VIENNA
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
606 HIGHWAY 63 S VIENNA, MO 65582
Location Phone
(573) 422-3636
Location Fax
(573) 422-3434
Mailing Address
PO BOX 579 ROLLA, MO 65402
Mailing Phone
(573) 426-2182
Mailing Fax
(573) 422-3434
Is Sole Proprietor?
No
Is Organization Subpart?
Yes
Enumeration Date
09-14-2010
Last Update Date
01-17-2019
Code Navigator

A primary care provider (PCP) like Phelps Health Medical Group Vienna sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Clinic/Center Rural Health

Taxonomy Code
261QR1300X
Type
Ambulatory Health Care Facilities
License No.
2007024375
License State
MO

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Anthem Bronze Pathway 10150 ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
  • Anthem Bronze Pathway 6900 ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
  • Anthem Bronze Pathway 7500 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
  • Anthem Catastrophic Pathway (+ Incentives) - EPO
  • Anthem Gold Pathway 2000 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
  • Anthem Heart Healthy Bronze Pathway 4900 ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
  • Anthem Heart Healthy Silver Pathway 3100 ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
  • Anthem Silver Pathway 5350 ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
  • Anthem Silver Pathway 6000 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
  • Anthem Silver Pathway 7200 ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

JANA M COOK

Authorized Official Title
VP, CHIEF FINANCIAL OFFICER
Authorized Official Phone
(573) 458-7916

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
594328304MEDICAID (05)MO 

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
26D1052781
Facility Type
Rural Health Clinic
Certificate Effective Date
January 01, 2026
Certificate Expiration Date
December 31, 2027
Laboratory Director
RACHELLE GORRELL
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Phelps Health Medical Group Vienna to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

Reviews for PHELPS HEALTH MEDICAL GROUP VIENNA

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1114235041, we treat the final digit (1) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 49. The final step is to find the difference between that total and the next multiple of ten (50 - 49 = 1).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
1
Unchanged
Pos 3
1
Doubled → 2
Pos 4
4
Unchanged
Pos 5
2
Doubled → 4
Pos 6
3
Unchanged
Pos 7
5
Doubled → 10 → 1 + 0
Pos 8
0
Unchanged
Pos 9
4
Doubled → 8
Check
1
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 1 → 2 2 → 4 5 → 10 → 1 4 → 8

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 1 + 2 + 4 + 4 + 3 + 1 + 0 + 0 + 8 + 24 = 49

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 49 is 50. The difference is the calculated check digit.

50 - 49 = 1
This NPI is valid
The calculated check digit is 1, which matches the last digit of 1114235041.

Other Providers at the Same Location


The following 5 providers are registered at the same or a nearby location.

Pharmacist
606 HIGHWAY 63 S
VIENNA, MO 65582
Family Medicine
606 HIGHWAY 63 S
VIENNA, MO 65582
Physician Assistant
606 HIGHWAY 63 S
VIENNA, MO 65582
Pharmacy (Long Term Care Pharmacy)
606 HIGHWAY 63 S
VIENNA, MO 65582
Pharmacy (Community/Retail Pharmacy)
606 HIGHWAY 63 S
VIENNA, MO 65582

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1114235041, enumerated as an "organization" on September 14, 2010.

The provider is located at 606 HIGHWAY 63 S VIENNA, MO 65582 and the phone number is (573) 422-3636.

Clinic/Center with taxonomy code 261QR1300X and a focus in Rural Health.

The provider might be accepting Accepts: Anthem Blue Cross and Blue Shield, Medicare and. Please consult your insurance carrier or call the provider to verify.