Physician Management Services of Southern Missouri, LLC
NPI 1164932893ActiveOrganization· Family Medicine· O Fallon, MO
Family Medicine in O Fallon, Missouri, registered in NPPES in October 2017, part of Vaxcare Corporation. The authorized official on file is Brett Kenefick, President. Enrolled in Medicare as part b supplier - centralized flu biller.
Overview
| NPI | 1164932893 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | Vaxcare Corporation |
| NPI issued | Oct 9, 2017 |
| Last updated in NPPES | Jul 24, 2026 |
| Certified by provider | Jul 24, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Family Medicine Primary | 207Q00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Centralized Flu Biller (TX) |
|---|
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