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CENTER FOR DIAGNOSTIC MEDICINE
NPI 1962134114
Family Medicine in Mount Vernon, MO

Active since June 27, 2022CLIA 26D2262032 · Waiver
320 W MOUNT VERNON BLVD, MOUNT VERNON, MO 65712(417) 461-0056(833) 707-1944 Get Directions Write a Review

NPPES record last updated: March 11, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Center For Diagnostic Medicine NPPES

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

CENTER FOR DIAGNOSTIC MEDICINE (NPI 1962134114) is a healthcare organization registered as a family medicine in Mount Vernon, Missouri and active in the NPI registry since June 2022. The organization holds a CLIA Waiver certificate valid through June 7, 2028 and lists Lisa Lynn Parker, Physician, as its authorized official.

NPPES Registry Identity

NPI1962134114
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameCIRCLE MAKER LLC
Location Address320 W MOUNT VERNON BLVDMount Vernon, MO 65712-1940
Mailing Address320 W Mount Vernon BlvdMount Vernon, MO 65712-1940 · (417) 461-0056
Phone(417) 461-0056
Fax(833) 707-1944
Organization SubpartNo
Authorized OfficialLisa Lynn ParkerPhysician · (417) 461-3009
Enumeration DateJune 27, 2022
Last NPPES UpdateMarch 11, 2023
NPPES CertifiedMarch 11, 2023
✔ NPI 1962134114 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
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.
320 W MOUNT VERNON BLVD, Mount Vernon, MO 65712
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Other Names 1

Doing Business AsCenter For Diagnostic Medicine

Other Identifiers 1

Medicaid205890106MO

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

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Center For Diagnostic Medicine is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

3

Medicare enrollment records show 3 clinicians reassign Medicare billing to Center For Diagnostic Medicine, which bills Medicare for the services they deliver. Of these, 1 practice at this address. They are listed nearest first.

Clinicians, nearest first (3)

Lisa Parker, MD
Family Practice
NPI 1578682324
320 W MOUNT VERNON BLVD
Mount Vernon, MO 65712
(417) 461-0056
✔ PECOS✔ Accepts MedicareSame address
Bethany Douglas, MSN FNP-C
Nurse Practitioner
NPI 1306658463
320 W MOUNT VERNON BLVD
Mount Vernon, MO 65712
(417) 461-0056
✔ PECOS✔ Accepts Medicare22 mi
Julia Eden, CNP
Nurse Practitioner
NPI 1821733833
104 E MAIN ST
Anderson, MO 64831
(417) 845-6984
✔ PECOS57 mi

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

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 26D2262032

Center For Diagnostic Medicine · Mount Vernon, MO
Active · expires Jun 7, 2028
CLIA Number26D2262032
Laboratory TypePhysician Office
Certificate Effective DateJune 8, 2026
Certificate Expiration DateJune 7, 2028
Laboratory DirectorLisa L. Parker
Laboratory Phone(417) 461-3009
Laboratory LocationCenter For Diagnostic Medicine320 W Mount Vernon Blvd, Mount Vernon, MO 65712
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only 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 Circle Maker LLC's NPI number?

The NPI number for Circle Maker LLC is 1962134114. It was assigned to this organization in the NPPES registry on June 27, 2022. The provider is doing business as Center For Diagnostic Medicine.

Where is Circle Maker LLC located?

Circle Maker LLC is located at 320 W Mount Vernon Blvd, Mount Vernon, MO 65712. The listed phone number is (417) 461-0056.

What is Circle Maker LLC's specialty?

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

Is Circle Maker LLC enrolled in Medicare?

Yes. Circle Maker LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Circle Maker LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians reassign their Medicare billing to Circle Maker LLC, in Family Practice and Nurse Practitioner. 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. Of these, 1 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Circle Maker LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 26D2262032) is associated with this NPI, valid through June 7, 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 Circle Maker LLC was last updated on March 11, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.