Carroll County Medical Clinic – Family Medicine Physician, NPI 1114135050

Carroll County Medical Clinic is a healthcare provider. based in Carrollton, Missouri. specializing in Family Medicine Physician. They hold a License No. 106594 (MO). The NPI Number for Carroll County Medical Clinic is 1114135050

Main info

Organization
Inactive
Name
Carroll County Medical Clinic
NPI
1114135050
Phone
(660) 542-3965
Address
1502 N JEFFERSON ST
Deactivation Date
29 October 2021
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience23
Completeness80
Years active:0State licenses:2Digital endpointsUpdated within 12 months

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Provider Addresses for Carroll County Medical Clinic

  • Carroll County Memorial Hospital, 1502, North Jefferson Street, Carrollton, Carroll County, Missouri, 64633, United States

    SUITE A B

    CARROLLTON, MO 646331948

    Phone: (660) 542-3965

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 64633)

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Reviews

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Frequently asked questions

How is Carroll County Medical Clinic identified in CMS data?
CMS-hosted NPPES data lists Carroll County Medical Clinic with NPI 1114135050.
Why is Carroll County Medical Clinic marked inactive in the NPI directory?
The public NPI listing for Carroll County Medical Clinic is not currently active; confirm directly with the practice or licensing boards.
What is Carroll County Medical Clinic's primary classification?
Family Medicine Physician is the headline specialty for Carroll County Medical Clinic here. Clinical services aligned with this taxonomy classification.
Where should I expect Carroll County Medical Clinic on a map?
Expect Carrollton, Missouri as a primary anchor for Carroll County Medical Clinic unless the record lists multiple sites.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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