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CENTRAL MISSOURI UROLOGY CLINIC, INC
NPI 1710940630
Specialist in Rolla, MO

Active since April 11, 2006CLIA 26D0713155 · Microscopy
1428 EAST 72 HIGHWAY, ROLLA, MO 65401(573) 364-1014(573) 364-6872 Get Directions Write a Review

NPPES record last updated: June 29, 2010. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Central Missouri Urology Clinic, Inc NPPES

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

CENTRAL MISSOURI UROLOGY CLINIC, INC (NPI 1710940630) is a healthcare organization registered as a specialist in Rolla, Missouri and active in the NPI registry since April 2006. The organization holds a CLIA Microscopy certificate valid through November 5, 2026 and lists Anthony Thomas Kaczmarek, President Urologist, as its authorized official.

NPPES Registry Identity

NPI1710940630
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NameCENTRAL MISSOURI UROLOGY CLINIC, INC
Location Address1428 EAST 72 HIGHWAYRolla, MO 65401
Mailing Address1428 East State Route 72Rolla, MO 65401 · (573) 364-1014 · Fax (573) 364-6872
Phone(573) 364-1014
Fax(573) 364-6872
Organization SubpartNo
Authorized OfficialAnthony Thomas KaczmarekPresident Urologist · (573) 364-1014
Enumeration DateApril 11, 2006
Last NPPES UpdateJune 29, 2010
✔ NPI 1710940630 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License✔ Licensed in MO · 110031
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
1428 EAST 72 HIGHWAY, Rolla, MO 65401
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Other Identifiers 3

Medicare ID-Type Unspecified000000565MO
Medicare UPINF32172MO
Medicaid208305102MO

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Sunflower Health Plan and more.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 for Provider-Performed Microscopy Procedures (PPMP) 26D0713155

Central Missouri Urology Clinic · Rolla, MO
Active · expires Nov 5, 2026
CLIA Number26D0713155
Laboratory TypePhysician Office
Certificate Effective DateNovember 6, 2024
Certificate Expiration DateNovember 5, 2026
Laboratory DirectorAnthony P. Kaczmarek
Laboratory Phone(573) 364-1014
Laboratory LocationCentral Missouri Urology Clinic1428 Hwy 72 East, Rolla, MO 65401
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

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 Central Missouri Urology Clinic, Inc's NPI number?

The NPI number for Central Missouri Urology Clinic, Inc is 1710940630. It was assigned to this organization in the NPPES registry on April 11, 2006.

Where is Central Missouri Urology Clinic, Inc located?

Central Missouri Urology Clinic, Inc is located at 1428 East 72 Highway, Rolla, MO 65401. The listed phone number is (573) 364-1014.

What is Central Missouri Urology Clinic, Inc's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Does Central Missouri Urology Clinic, Inc hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 26D0713155) is associated with this NPI, valid through November 5, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Central Missouri Urology Clinic, Inc accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health and Ambetter from Sunflower Health Plan and 2 other insurers list Central Missouri Urology Clinic, 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 Central Missouri Urology Clinic, Inc was last updated on June 29, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.