BOURBON MEDICAL OFFICE
NPI 1184174567
Clinic/Center - Multi-Specialty in Bourbon, MO

NPI Status: Active since October 10, 2016

Contact Information

240 COLLEGE ST
BOURBON, MO
ZIP 65441
Phone: (573) 732-5004

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  • Organization
  • Clinic/Center
  • Multi-Specialty
  • CLIA Number: 26D0876487
  • CLIA Cert. Type: Practitioner Other
  • CLIA Exp. Date: 05-04-2027

About BOURBON MEDICAL OFFICE

This page provides the complete NPI Profile along with additional information for Bourbon Medical Office, a provider established in Bourbon, Missouri operating as a Clinic/center, focusing in multi-specialty . The healthcare provider is registered in the NPI registry with number 1184174567 assigned on October 2016. The practitioner's primary taxonomy code is 261QM1300X. The provider is registered as an organization and their NPI record was last updated 5 years ago. The provider's is doing business as Bourbon Medical Office. The authorized official of this NPI record is Mr. Tony L Schwarm (President)

NPI
1184174567
Provider Legal Name
MISSOURI BAPTIST HOSPITAL OF SULLIVAN
Other Organization Name
BOURBON MEDICAL OFFICE
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
240 COLLEGE ST BOURBON, MO 65441
Location Phone
(573) 732-5004
Mailing Address
751 SAPPINGTON BRIDGE RD ADMINISTRATION SULLIVAN, MO 63080
Mailing Phone
(573) 468-4186
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
10-10-2016
Last Update Date
03-23-2021
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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 Multi-Specialty

Taxonomy Code
261QM1300X
Type
Ambulatory Health Care Facilities

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

MR. TONY L SCHWARM

Authorized Official Title
PRESIDENT
Authorized Official Phone
(573) 468-4186

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
26D0876487
Facility Type
Practitioner Other
Certificate Effective Date
May 05, 2025
Certificate Expiration Date
May 04, 2027
Laboratory Director
MEGAN TURNBOUGH
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Bourbon Medical Office 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.

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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 1184174567, we treat the final digit (7) 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 63. The final step is to find the difference between that total and the next multiple of ten (70 - 63 = 7).

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
8
Doubled → 16 → 1 + 6
Pos 4
4
Unchanged
Pos 5
1
Doubled → 2
Pos 6
7
Unchanged
Pos 7
4
Doubled → 8
Pos 8
5
Unchanged
Pos 9
6
Doubled → 12 → 1 + 2
Check
7
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 8 → 16 → 7 1 → 2 4 → 8 6 → 12 → 3

Step 2: Add all digits plus the NPI constant

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

2 + 1 + 1 + 6 + 4 + 2 + 7 + 8 + 5 + 1 + 2 + 24 = 63

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

The next multiple of ten after 63 is 70. The difference is the calculated check digit.

70 - 63 = 7
This NPI is valid
The calculated check digit is 7, which matches the last digit of 1184174567.

Other Providers at the Same Location


The following 2 providers are registered at the same or a nearby location.

Nurse Practitioner (Family)
240 COLLEGE ST
BOURBON, MO 65441
Clinic/Center (Rural Health)
240 COLLEGE ST
BOURBON, MO 65441

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1184174567, enumerated as an "organization" on October 10, 2016.

The provider is located at 240 COLLEGE ST BOURBON, MO 65441 and the phone number is (573) 732-5004.

Clinic/Center with taxonomy code 261QM1300X and a focus in Multi-Specialty.