NPIMap

Individual provider Active NPI

Jeffrey Jon Hull, MD

  • Specialist
  • West Plains, MO
National Provider Identifier
1033106539
Registry record updated May 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
2002004660 Issued in MO
Practice address
1409 Doctors Drive
West Plains, MO 65775-4235
Phone
(417) 255-1373
Fax
(866) 463-8723
NPI assigned
Sep 30, 2005
Last updated
May 7, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 2002004660 MO Primary

Addresses

Primary practice location

1409 Doctors Drive
West Plains, MO 65775-4235

Mailing address

1409 Doctors Drive
West Plains, MO 65775-4235
Phone (417) 255-1373

Other identifiers 1

IdentifierTypeStateIssuer
205810708MedicaidMO

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
I20060324000360 MO Practitioner - Otolaryngology 0042244675 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Uniformed Services Uhs Fe Hebert School of Med, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern Missouri Ear, Nose and Throat, PCGroup PAC ID 9638187131, 3 clinicians

Practice addresses (Care Compare)

1409 Doctors Dr
West Plains, MO 65775-4754
Phone (417) 255-1373

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Melanoma (skin cancer) excision1-10
Removal of tissue1-10
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2002004660MOMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Missouri Ear, Nose & Throat, PC Specialist CurrentSince Feb 15, 2006 Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

1409 Doctors Dr
West Plains, MO 65775
Phone (417) 255-1373

3100 Independence Sq
West Plains, MO 65775
Phone (417) 255-1373

Networks

  • devoted network organization-2b183dd2-4e80-4977-80a6-4fdf0df4361d
  • IA HMO C-SNP
  • IA HMO

Organizations & group practices 2

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

Hospital & facility affiliations 11

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": "1128038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1336348800000",
    "number": "1033106539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1409 DOCTORS DRIVE",
            "city": "WEST PLAINS",
            "state": "MO",
            "postal_code": "657754235",
            "telephone_number": "417-255-1373",
            "fax_number": "866-463-8723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1409 DOCTORS DRIVE",
            "city": "WEST PLAINS",
            "state": "MO",
            "postal_code": "657754235",
            "telephone_number": "417-255-1373",
            "fax_number": "866-463-8723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HULL",
        "first_name": "JEFFREY",
        "middle_name": "JON",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-30",
        "last_updated": "2012-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MO",
            "license": "2002004660",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "205810708",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Plains, MO

Sources for this page

Verify at the official NPI Registry.