Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

St Joseph Specialty Clinic PC

Organization Surgery Physician · NPI 1962424895

St Joseph Specialty Clinic PC is a Surgery Physician in Bethany, Missouri. Licensed in Missouri. Registered with an NPI since 2006.

Licensed in
MO
In the registry since
2006
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

2600 Miller St
Bethany, MO 64424-2701
Phone: (660) 425-0253
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgery Physician (primary) Taxonomy 208600000X · Licence 112862 (MO)

Record details

NPI number1962424895
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Kenneth Shewell — Secretary · (816) 866-5105
Other names St Joseph Specialty Clinic Pc
NPI enumeratedJuly 23, 2006
Last updated in NPPESJanuary 4, 2023
Certification dateJanuary 4, 2023
Mailing addressPo Box 8657, Saint Joseph, MO 64508-8657

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