Phelps Health Medical Group Rolla – Clinic/Center, NPI 1124237227
Clinic/Center
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Phelps Health Medical Group Rolla
1050, West 10th Street, Rolla, Phelps County, Missouri, 65409, United States
ROLLA, MO 654012905
Phone: (573) 364-9000
Fax: (573) 458-3952
Type: Location
1060 W 10th St
Rolla, MO 654012905
Phone: (855) 406-3324
Fax: (573) 458-8363
Type: Location
1000 W 10th St
Rolla, MO 654012905
Phone: (573) 364-9000
Fax: (573) 426-2108
Type: Location
1201 Hauck Dr
Rolla, MO 654014900
Phone: (573) 364-8818
Type: Location
1000 Gw Ln
Waynesville, MO 655832339
Phone: (573) 774-2715
Fax: (573) 202-2410
Type: Location
1422 S Sam Houston Blvd
Houston, MO 654832130
Phone: (573) 364-9000
Fax: (573) 426-2108
Type: Location
PO BOX 579
ROLLA, MO 654020579
Phone: (573) 426-2182
Fax: (573) 426-5341
Type: Mailing
603 S Bishop Ave
Rolla, MO 654014320
Phone: (573) 426-4411
Fax: (573) 426-4403
Type: Location
1428 E State Hwy 72
Rolla, MO 654013988
Phone: (573) 364-1014
Fax: (573) 364-6872
Type: Location
35629 Highway 72
Salem, MO 655607217
Phone: (855) 406-3324
Fax: (573) 458-8363
Type: Location
1415 W Scenic Rivers Blvd
Salem, MO 655602840
Phone: (573) 729-5533
Fax: (573) 202-2466
Type: Location
1000 N Jefferson St
Saint James, MO 655591078
Phone: (573) 265-8840
Fax: (573) 202-2474
Type: Location
600 Blues Lake Pkwy
Rolla, MO 654018022
Phone: (573) 364-8822
Fax: (573) 202-2402
Type: Location
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.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2007-08-29
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2024-05-31 (738 days ago).
Enrollment records
1
Earliest due date
2024-05-31
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20070829000437 | O | Clinic/Group Practice | MO | 2024-05-31 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
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 65401)
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