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

Active since September 14, 2010CLIA 26D1052781 · Waiver
606 HIGHWAY 63 S, VIENNA, MO 65582(573) 422-3636(573) 422-3434 Get Directions Write a Review

NPPES record last updated: January 17, 2019. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jan 17, 2019, Nov 22, 2017 (2 updates tracked since 2017).

About Phelps Health Medical Group Vienna NPPES

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

PHELPS HEALTH MEDICAL GROUP VIENNA (NPI 1114235041) is a healthcare organization registered as a rural health in Vienna, Missouri and active in the NPI registry since September 2010. The organization holds a CLIA Waiver certificate valid through December 31, 2027 and lists Jana M Cook, Vp, Chief Financial Officer, as its authorized official.

NPPES Registry Identity

NPI1114235041
Entity TypeOrganization
Primary Taxonomy261QR1300X
Legal Business NamePCRMC MEDICAL GROUP, INC
Location Address606 HIGHWAY 63 SVienna, MO 65582-8101
Mailing AddressPo Box 579Rolla, MO 65402 · (573) 426-2182 · Fax (573) 426-5341
Phone(573) 422-3636
Fax(573) 422-3434
Organization SubpartYes
Authorized OfficialJana M CookVp, Chief Financial Officer · (573) 458-7916
Enumeration DateSeptember 14, 2010
Last NPPES UpdateJanuary 17, 20192 updates tracked since enumeration
✔ NPI 1114235041 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Rural HealthAmbulatory Health Care Facilities
Taxonomy Code261QR1300X
License✔ Licensed in MO · 2007024375
606 HIGHWAY 63 S, Vienna, MO 65582
Open in Google Maps ↗

Other Names 1

Doing Business AsPhelps Health Medical Group Vienna

Other Identifiers 1

Medicaid594328304MO

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield.Insurance ›

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 26D1052781

Phelps Health · Vienna, MO
Active · expires Dec 31, 2027
CLIA Number26D1052781
Laboratory TypeRural Health Clinic
Certificate Effective DateJanuary 1, 2026
Certificate Expiration DateDecember 31, 2027
Laboratory DirectorRachelle Gorrell
Laboratory Phone(573) 422-3636
Laboratory LocationPhelps Health606 Hwy 63 S, Vienna, MO 65582
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 4

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

JENNIFER RENAE BERHORST PHARM D
Pharmacist
606 HIGHWAY 63 S
VIENNA, MO 65582
Maries County (573) 422-6400
VIENNA HEALTH CARE
Family Medicine
606 HIGHWAY 63 S
VIENNA, MO 65582
Maries County (573) 422-3636
MEDLEY PHARMACY INC
Pharmacy (Long Term Care Pharmacy)
606 HIGHWAY 63 S
VIENNA, MO 65582
Maries County (573) 422-6400
MEDLEY PHARMACY INC
Pharmacy (Community/Retail Pharmacy)
606 HIGHWAY 63 S
VIENNA, MO 65582
Maries County (573) 422-6400

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Pcrmc Medical Group, Inc's NPI number?

The NPI number for Pcrmc Medical Group, Inc is 1114235041. It was assigned to this organization in the NPPES registry on September 14, 2010. The provider is doing business as Phelps Health Medical Group Vienna.

Where is Pcrmc Medical Group, Inc located?

Pcrmc Medical Group, Inc is located at 606 Highway 63 S, Vienna, MO 65582. The listed phone number is (573) 422-3636.

What is Pcrmc Medical Group, Inc's specialty?

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

Does Pcrmc Medical Group, Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 26D1052781) is associated with this NPI, valid through December 31, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Pcrmc Medical Group, Inc accept?

Health plans from Anthem Blue Cross and Blue Shield list Pcrmc Medical Group, Inc as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Pcrmc Medical Group, Inc was last updated on January 17, 2019. NPI Profile syncs with the weekly NPPES data releases published by CMS.