NPIMap

Individual provider Active NPI

Justin James Dillingham, D.O.

  • Family Medicine Physician
  • Joplin, MO
National Provider Identifier
1003103490
Registry record updated Nov 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2014010517 Issued in MO
Practice address
3126 S Jackson Ave
Ste 101
Joplin, MO 64804-2534
Phone
(417) 208-3465
NPI assigned
Jul 6, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2014010517 MO Primary

Addresses

Primary practice location

3126 S Jackson Ave
Ste 101
Joplin, MO 64804-2534

Mailing address

3126 S Jackson Ave
Ste 101
Joplin, MO 64804-2534
Phone (417) 208-3465

Other identifiers 1

IdentifierTypeStateIssuer
1003103490MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140701002123 MO Practitioner - Family Practice 0648495838 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Freeman-Oak Hill Health SystemGroup PAC ID 8325942253, 385 clinicians
Freeman Neosho HospitalGroup PAC ID 4284624552, shared by 6 NPIs, 43 clinicians

Practice addresses (Care Compare)

1606 Olive St
Seneca, MO 64865-9247
Phone (417) 776-5900

336 S Jefferson St
Freeman Neosho Physician Group
Neosho, MO 64850-1769
Phone (417) 455-4200

510 Park St
Anderson, MO 64831-9280
Phone (417) 845-0545

Hospital & facility affiliations

  • Integrity Home Care + Hospice Home health agency, Springfield, MO, CCN 267576
  • Amedisys Home Health of Missouri Home health agency, Joplin, MO, CCN 267606
  • Freeman Neosho Hospital Hospital, Neosho, MO, CCN 261331
  • Freeman Health System - Freeman West Hospital, Joplin, MO, CCN 260137

Merit-based Incentive Payment System (MIPS)

Final score
81.37 of 100Reported as group
Quality
60.15
Promoting interoperability
100
Improvement activities
40
Cost
77.74

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
2014010517MOMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Freeman Neosho Hospital CurrentSince Jan 1, 2026 Accepting new patients
Freeman-Oak Hill Health System Family Medicine CurrentSince Jan 11, 2023 Accepting new patients
Freeman Neosho Hospital Family Medicine CurrentSince Feb 21, 2022 Accepting new patients
Freeman Neosho Hospital CurrentSince Feb 21, 2022 Accepting new patients
Freeman-Oak Hill Health System Past Accepting new patients

Locations

510 Park St
Anderson, MO 64831
Phone (417) 845-0545

1102 W 32nd St
Joplin, MO 64804
Phone (417) 347-1078

307 W 11th St
Lamar, MO 64759
Phone (417) 682-3300

336 S Jefferson St
Neosho, MO 64850
Phone (417) 451-4200

113 W Hickory St
Neosho, MO 64850
Phone (417) 347-1078

1606 Olive St
Seneca, MO 64865
Phone (417) 776-5900

Networks

  • IL PPO Downstate
  • devoted network organization-734447cc-691b-4aa7-a112-9c9c8698dcc9
  • IA HMO C-SNP
  • devoted network organization-2b183dd2-4e80-4977-80a6-4fdf0df4361d
  • IA HMO
  • devoted network organization-27eb9117-6975-449a-a7ad-909243995ddc

Interoperability endpoints

  • Direct secure messaging: jdillingham488813@directb.mercy.net

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Freeman Neosho HospitalNeosho, MO, CCN 261331 Hospital Corporate Director Apr 1, 2023
Freeman Clinic of AndersonAnderson, MO, CCN 268773 Rural health clinic Corporate Director Apr 1, 2023

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1309910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415318400000",
    "number": "1003103490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3126 S JACKSON AVE",
            "address_2": "STE 101",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648042534",
            "telephone_number": "417-208-3465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3126 S JACKSON AVE",
            "address_2": "STE 101",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648042534",
            "telephone_number": "417-208-3465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DILLINGHAM",
        "first_name": "JUSTIN",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-06",
        "last_updated": "2014-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2014010517",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1003103490",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Joplin, MO

Sources for this page

Verify at the official NPI Registry.