Active NPI
James S. Denninghoff, M.D.
- Otolaryngology Physician
- Columbia, MO
National Provider Identifier
1033104005
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- License
- 36275
- Practice address
- 1701 E Broadway
Suite 304
Columbia, MO 65201-8018 - Phone
- (573) 815-0662
- Fax
- (573) 443-1162
- NPI assigned
- Sep 15, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | 36275 | MO | Primary |
Addresses
Primary practice location
1701 E Broadway
Suite 304
Columbia, MO 65201-8018
Mailing address
1701 E Broadway
Suite 304
Columbia, MO 65201-8018
Phone (573) 815-0662
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 202330700 | Medicaid | MO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Jul 1, 2024 through Jul 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 36275 | MO | MD | Otolaryngology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Missouri Ear Nose and Throat Center | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Medical Specialty Clinic/Center
- Columbia, MO
- NPI 1033319140
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1126742400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1464048000000",
"number": "1033104005",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1701 E BROADWAY",
"address_2": "SUITE 304",
"city": "COLUMBIA",
"state": "MO",
"postal_code": "652018018",
"telephone_number": "573-815-0662",
"fax_number": "573-443-1162"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1701 E BROADWAY",
"address_2": "SUITE 304",
"city": "COLUMBIA",
"state": "MO",
"postal_code": "652018018",
"telephone_number": "573-815-0662",
"fax_number": "573-443-1162"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DENNINGHOFF",
"first_name": "JAMES",
"middle_name": "S.",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-09-15",
"last_updated": "2016-05-24",
"status": "A"
},
"taxonomies": [
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "MO",
"license": "36275",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "202330700",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Columbia, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.