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CORNERSTONE FAMILY MEDICINE LLC
NPI 1164164711
Clinic/Center in Mexico, MO

Active since April 12, 2022CLIA 26D2283663 · Waiver
605 E PROMENADE ST, MEXICO, MO 65265(573) 200-6078(833) 817-7109 Get Directions Write a Review

NPPES record last updated: April 12, 2022. Verified against the NPPES registry weekly; last sync: October 04, 2026.

About Cornerstone Family Medicine Llc NPPES

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

CORNERSTONE FAMILY MEDICINE LLC (NPI 1164164711) is a healthcare organization registered as a clinic/center in Mexico, Missouri and active in the NPI registry since April 2022. The organization holds a CLIA Waiver certificate valid through June 11, 2027 and lists Zachary Joel Treat, Physician, as its authorized official.

NPPES Registry Identity

NPI1164164711
Entity TypeOrganization
Primary Taxonomy261Q00000X
Legal Business NameCORNERSTONE FAMILY MEDICINE LLC
Location Address605 E PROMENADE STMexico, MO 65265-2926
Mailing Address605 E Promenade StMexico, MO 65265-2926 · (573) 200-6078 · Fax (833) 817-7109
Phone(573) 200-6078
Fax(833) 817-7109
Organization SubpartNo
Authorized OfficialZachary Joel TreatPhysician · (314) 437-9917
Enumeration DateApril 12, 2022
NPPES CertifiedApril 12, 2022
✔ NPI 1164164711 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/CenterAmbulatory Health Care Facilities
Taxonomy Code261Q00000X
Definition
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
605 E PROMENADE ST, Mexico, MO 65265
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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 26D2283663

Cornerstone Family Medicine-Fulton · Fulton, MO
Active · expires Jun 11, 2027
CLIA Number26D2283663
Laboratory TypePhysician Office
Certificate Effective DateJune 12, 2025
Certificate Expiration DateJune 11, 2027
Laboratory DirectorAlexander C. Finck
Laboratory Phone(573) 200-6078
Laboratory LocationCornerstone Family Medicine-Fulton500 Market St, Suite 300, Fulton, MO 65251
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

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

SSM HEALTH BUSINESSES
Hospice Care, Community Based
605 E PROMENADE ST
MEXICO, MO 65265
Audrain County (573) 582-8850
SSM HEALTH BUSINESSES
Home Health
605 E PROMENADE ST
MEXICO, MO 65265
Audrain County (573) 582-8850
JANICE LYNN BROCKUS CCC-SLP
Speech-Language Pathologist
605 E PROMENADE ST
MEXICO, MO 65265
Audrain County (573) 581-1332

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 Cornerstone Family Medicine LLC's NPI number?

The NPI number for Cornerstone Family Medicine LLC is 1164164711. It was assigned to this organization in the NPPES registry on April 12, 2022.

Where is Cornerstone Family Medicine LLC located?

Cornerstone Family Medicine LLC is located at 605 E Promenade St, Mexico, MO 65265. The listed phone number is (573) 200-6078.

What is Cornerstone Family Medicine LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

Does Cornerstone Family Medicine LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 26D2283663) is associated with this NPI, valid through June 11, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Cornerstone Family Medicine LLC was last updated on April 12, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.