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LIBERTY MEDICAL CENTER, PC
NPI 1609144450
Non-Pharmacy Dispensing Site in Liberty, MO

Active since December 08, 2011CLIA 26D1039971 · Waiver
1504 NE 96TH ST STE A, LIBERTY, MO 64068(816) 415-2233(816) 415-2218 Get Directions Write a Review

NPPES record last updated: March 20, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Liberty Medical Center, Pc NPPES

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

LIBERTY MEDICAL CENTER, PC (NPI 1609144450) is a healthcare organization registered as a non-pharmacy dispensing site in Liberty, Missouri and active in the NPI registry since December 2011. The organization holds a CLIA Waiver certificate valid through April 26, 2027 and lists Shelly Boomgaarden, Billing, as its authorized official.

NPPES Registry Identity

NPI1609144450
Entity TypeOrganization
Primary Taxonomy332900000X
Legal Business NameLIBERTY MEDICAL CENTER, PC
Location Address1504 NE 96TH ST STE ALiberty, MO 64068-1351
Mailing Address2980 N Beverly Glen Cir Ste 100Los Angeles, CA 90077-1728 · (310) 474-9809 · Fax (888) 431-8819
Phone(816) 415-2233
Fax(816) 415-2218
Organization SubpartYesParent: Liberty Medical Center Pc
Authorized OfficialShelly BoomgaardenBilling · (816) 415-2233
Enumeration DateDecember 8, 2011
Last NPPES UpdateMarch 20, 2026
NPPES CertifiedMarch 20, 2026
✔ NPI 1609144450 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNon-Pharmacy Dispensing SiteSuppliers
Taxonomy Code332900000X
Definition
A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.)
1504 NE 96TH ST STE A, Liberty, MO 64068
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Sanford Health Plan.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 26D1039971

Liberty Medical Center PC · Liberty, MO
Active · expires Apr 26, 2027
CLIA Number26D1039971
Laboratory TypePhysician Office
Certificate Effective DateApril 27, 2025
Certificate Expiration DateApril 26, 2027
Laboratory DirectorRodney J. Malisos
Laboratory Phone(816) 415-2233
Laboratory LocationLiberty Medical Center PC1504 NE 96th Street, Liberty, MO 64068
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 2

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

LIBERTY MEDICAL CENTER PC
Family Medicine
1504 NE 96TH ST STE A
LIBERTY, MO 64068
Clay County (816) 415-2233
MELINDA HEUTINCK ANP-C, ARNP
Nurse Practitioner (Adult Health)
1504 NE 96TH ST STE A
LIBERTY, MO 64068
Clay County (816) 415-2233

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 Liberty Medical Center, PC's NPI number?

The NPI number for Liberty Medical Center, PC is 1609144450. It was assigned to this organization in the NPPES registry on December 8, 2011.

Where is Liberty Medical Center, PC located?

Liberty Medical Center, PC is located at 1504 NE 96th St Ste A, Liberty, MO 64068. The listed phone number is (816) 415-2233.

What is Liberty Medical Center, PC's specialty?

The primary specialty registered for this NPI is Non-Pharmacy Dispensing Site with taxonomy code 332900000X.

Does Liberty Medical Center, PC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 26D1039971) is associated with this NPI, valid through April 26, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Liberty Medical Center, PC accept?

Health plans from Sanford Health Plan list Liberty Medical Center, PC 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 Liberty Medical Center, PC was last updated on March 20, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.