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KIRKSVILLE SPECIALTY CLINIC LLC
NPI 1386126308
Internal Medicine - Rheumatology in Kirksville, MO

Active since September 06, 2018
1108 E PATTERSON ST STE 10, KIRKSVILLE, MO 63501(660) 956-0487(660) 956-0446 Get Directions Write a Review

NPPES record last updated: February 11, 2020. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Feb 11, 2020, Feb 7, 2020, Jan 21, 2020 and 1 more (4 updates tracked since 2018).

About Kirksville Specialty Clinic Llc NPPES

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

KIRKSVILLE SPECIALTY CLINIC LLC (NPI 1386126308) is a healthcare organization registered as a rheumatology in Kirksville, Missouri and active in the NPI registry since September 2018. The organization lists David Neuendorf, Ceo, as its authorized official.

NPPES Registry Identity

NPI1386126308
Entity TypeOrganization
Primary Taxonomy207RR0500X
Legal Business NameKIRKSVILLE SPECIALTY CLINIC LLC
Location Address1108 E PATTERSON ST STE 10Kirksville, MO 63501-4043
Mailing Address1108 E Patterson St Ste 10Kirksville, MO 63501-4043 · (660) 956-0487 · Fax (660) 956-0446
Phone(660) 956-0487
Fax(660) 956-0446
Organization SubpartNo
Authorized OfficialDavid NeuendorfCeo · (573) 886-8904
Enumeration DateSeptember 6, 2018
Last NPPES UpdateFebruary 11, 20204 updates tracked since enumeration
✔ NPI 1386126308 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · RheumatologyAllopathic & Osteopathic Physicians
Taxonomy Code207RR0500X
License✔ Licensed in MO · R6C73
Definition
An internist who treats diseases of joints, muscle, bones and tendons. This specialist diagnoses and treats arthritis, back pain, muscle strains, common athletic injuries and collagen diseases.
Also ListedClinic/Center · Medical SpecialtyTaxonomy 261QM2500X
1108 E PATTERSON ST STE 10, Kirksville, MO 63501
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kirksville Specialty Clinic Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

5

Medicare enrollment records show 5 clinicians reassign Medicare billing to Kirksville Specialty Clinic LLC, which bills Medicare for the services they deliver. Of these, 1 practice within 10 miles. They are listed nearest first.

Clinicians, nearest first (5)

Lawrence Ciesemier, D.O
Allergy/Immunology
NPI 1952464190
610 ROSEWOOD DR
Kirksville, MO 63501
(660) 627-2553
✔ PECOS✔ Accepts Medicare1.8 mi
Robert Jackson, D.O.
Rheumatology
NPI 1730293705
SIGLER AVE
Memphis, MO 63555
(660) 465-2828
✔ PECOS✔ Accepts Medicare30 mi
Tonia Nerini, NP-C
Nurse Practitioner
NPI 1790220606
34294 STATE HIGHWAY FF
Bevier, MO 63532
(660) 346-8558
✔ PECOS✔ Accepts Medicare34 mi
Heather Evans, MSN, FNP-C
Nurse Practitioner
NPI 1700513538
614 W LOCKLING ST
Brookfield, MO 64628
(660) 268-4006
✔ PECOS38 mi
Shayla Sanders, FNP-BC
Nurse Practitioner
NPI 1841607900
1501 WESTPORT RD
Kansas City, MO 64111
(816) 282-0131
✔ PECOS✔ Accepts Medicare133 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Kirksville Specialty Clinic LLC's NPI number?

The NPI number for Kirksville Specialty Clinic LLC is 1386126308. It was assigned to this organization in the NPPES registry on September 6, 2018.

Where is Kirksville Specialty Clinic LLC located?

Kirksville Specialty Clinic LLC is located at 1108 E Patterson St Ste 10, Kirksville, MO 63501. The listed phone number is (660) 956-0487.

What is Kirksville Specialty Clinic LLC's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Rheumatology, with taxonomy code 207RR0500X.

Is Kirksville Specialty Clinic LLC enrolled in Medicare?

Yes. Kirksville Specialty Clinic LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Kirksville Specialty Clinic LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 5 clinicians in 3 Medicare specialties reassign their Medicare billing to Kirksville Specialty Clinic LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (3), Allergy/Immunology (1) and Rheumatology (1). Of these, 1 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Kirksville Specialty Clinic LLC was last updated on February 11, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.