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MERCY CLINIC PEDIATRICS- LEBANON
NPI 1770612590
Clinic/Center - Rural Health in Lebanon, MO

Active since March 05, 2007
120 HOSPITAL DR STE 350, LEBANON, MO 65536(417) 533-6746(417) 533-6740 Get Directions Write a Review

NPPES record last updated: October 14, 2020. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Oct 14, 2020, Oct 5, 2020, Dec 4, 2018 and 1 more (4 updates tracked since 2018).

About Mercy Clinic Pediatrics- Lebanon NPPES

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

MERCY CLINIC PEDIATRICS- LEBANON (NPI 1770612590) is a healthcare organization registered as a rural health in Lebanon, Missouri and active in the NPI registry since March 2007. The organization lists William Roberts, Vice President Finance, as its authorized official.

NPPES Registry Identity

NPI1770612590
Entity TypeOrganization
Primary Taxonomy261QR1300X
Legal Business NameMERCY CLINIC SPRINGFIELD COMMUNITIES
Location Address120 HOSPITAL DR STE 350Lebanon, MO 65536-9253
Mailing Address1570 W Battlefield St Ste 110Springfield, MO 65807-4163 · (417) 820-7133 · Fax (417) 820-0586
Phone(417) 533-6746
Fax(417) 533-6740
Organization SubpartNo
Authorized OfficialWilliam RobertsVice President Finance · (417) 820-7363
Enumeration DateMarch 5, 2007
Last NPPES UpdateOctober 14, 20204 updates tracked since enumeration
NPPES CertifiedOctober 14, 2020
✔ NPI 1770612590 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinic/Center · Rural HealthAmbulatory Health Care Facilities
Taxonomy Code261QR1300X
Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X · License 123516 (MO)
120 HOSPITAL DR STE 350, Lebanon, MO 65536
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Other Names 1

Doing Business AsMercy Clinic Pediatrics- Lebanon

Other Identifiers 1

Medicaid597785609MO

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

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 of Waiver 26D1051385

Mercy Clinic Pediatrics Smith Glynn Callaway · Springfield, MO
Active · expires Feb 29, 2028
CLIA Number26D1051385
Laboratory TypePhysician Office
Certificate Effective DateMarch 1, 2026
Certificate Expiration DateFebruary 29, 2028
Laboratory DirectorDr. Emmanuel Obafemi-Ajayl
Laboratory Phone(417) 885-0810
Laboratory LocationMercy Clinic Pediatrics Smith Glynn Callaway3231 S National, Springfield, MO 65807
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.

DR. MAHMOUD HALAWA M.D.
Pediatrics
120 HOSPITAL DR STE 350
LEBANON, MO 65536
Laclede County (417) 533-6729
AKBAR ZAMAN KHAN M.D.
Pediatrics
120 HOSPITAL DR STE 350
LEBANON, MO 65536
Laclede County (417) 533-6729

Frequently Asked Questions

What is MERCY CLINIC SPRINGFIELD COMMUNITIES's NPI number?

The NPI number assigned to this healthcare provider is 1770612590, enumerated as an "organization" on March 05, 2007.

Where is the provider located?

The provider is located at 120 HOSPITAL DR STE 350 LEBANON, MO 65536 and the phone number is (417) 533-6746.

What is the provider's specialty?

Clinic/Center with taxonomy code 261QR1300X and a focus in Rural Health.

What insurance does MERCY CLINIC SPRINGFIELD COMMUNITIES accept?

The provider might be accepting Accepts: Ambetter from Arkansas Health & Wellness, Ambetter. Please consult your insurance carrier or call the provider to verify.