OAK GROVE MEDICAL CLINIC
NPI 1811293582
Family Medicine in Oak Grove, MO

Active since January 28, 2011CLIA 26D0443087 · Waiver
1900 S BROADWAY, OAK GROVE, MO 64075(816) 690-6566(816) 625-8276 Get Directions Write a Review

NPPES record last updated: May 4, 2011. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Oak Grove Medical Clinic NPPES

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

OAK GROVE MEDICAL CLINIC (NPI 1811293582) is a healthcare organization registered as a family medicine in Oak Grove, Missouri and active in the NPI registry since January 2011. The organization holds a CLIA Waiver certificate valid through July 5, 2028 and lists Steven R Cleary, Vp/cfo, as its authorized official.

NPPES Registry Identity

NPI1811293582
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameCARONDELET PHYSICIAN SERVICES INC
Location Address1900 S BROADWAYOak Grove, MO 64075-9020
Mailing Address801 Nw Saint Mary Dr, Suite 230Blue Springs, MO 64014-2524 · (816) 655-5792 · Fax (816) 655-5787
Fax(816) 625-8276
Organization SubpartYesParent: Carondelet Health
Authorized OfficialSteven R ClearyVp/cfo · (816) 943-2819
Enumeration DateJanuary 28, 2011
Last NPPES UpdateMay 4, 2011
NPI 1811293582 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License Licensed in MO · 34421
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
1900 S BROADWAY, Oak Grove, MO 64075

Other Names 1

Other NameOak Grove Medical Clinic

Other Identifiers 3

Other39532013Bcbs Of Kansas City
Medicaid501269500MO
Medicare PINY360000MO

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

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 26D0443087

Oak Grove Medical Clinic · Oak Grove, MO
Active · expires Jul 5, 2028
CLIA Number26D0443087
Laboratory TypePhysician Office
Certificate Effective DateJuly 6, 2026
Certificate Expiration DateJuly 5, 2028
Laboratory DirectorMaggie T. Ngar
Laboratory Phone(816) 690-6566
Laboratory LocationOak Grove Medical Clinic302 SE Salem, Oak Grove, MO 64075
CLIA data matches this NPI record on: 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.

Clinic/Center (Primary Care)
1900 S BROADWAY
OAK GROVE, MN 64075
Nurse Practitioner (Family)
1900 S BROADWAY, BOX 670
OAK GROVE, MO 64075

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 Carondelet Physician Services Inc's NPI number?

The NPI number for Carondelet Physician Services Inc is 1811293582. It was assigned to this organization in the NPPES registry on January 28, 2011. The provider is also known as Oak Grove Medical Clinic.

Where is Carondelet Physician Services Inc located?

Carondelet Physician Services Inc is located at 1900 S Broadway, Oak Grove, MO 64075. The listed phone number is (816) 690-6566.

What is Carondelet Physician Services Inc's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Carondelet Physician Services Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 26D0443087) is associated with this NPI, valid through July 5, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Carondelet Physician Services Inc was last updated on May 4, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.