William Russell Detten, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

R4P90 Issued in MO

Practice address

1530 E Republic Rd
Springfield, MO 65804-6530

Phone

(417) 269-1362

Fax

(417) 269-1372

NPI assigned

Aug 30, 2006

Last updated

Nov 12, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Merit-based Incentive Payment System (MIPS)

Final score

85.78 of 100Reported as group

Quality

74.39

Promoting interoperability

100

Improvement activities

40

Cost

78.21

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: william.detten@cernerdirect.coxhealth.com

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.

• Lester E Cox Medical Centers

  dba CoxHealth Center Campbell

  • Family Medicine Physician
  • Springfield, MO
  • NPI 1447324660
  Medicare reassignment NPD
• Lester E Cox Medical Centers

  dba Coxhealth Center Steeplechase

  • Family Medicine Physician
  • Springfield, MO
  • NPI 1508928623
  Medicare reassignment NPD
• Lester E Cox Medical Centers

  dba RS Radiology

  • Diagnostic Radiology Physician
  • Springfield, MO
  • NPI 1285070631
  NPD
• Lester E Cox Medical Centers

  dba CoxHealth Springfield Inpatient Physicians

  • Hospitalist Physician
  • Springfield, MO
  • NPI 1902969272
  NPD (past)

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352678400000",
    "number": "1033229935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4046",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658084046",
            "telephone_number": "417-269-1362",
            "fax_number": "417-269-1372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1530 E REPUBLIC RD",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658046530",
            "telephone_number": "417-269-1362",
            "fax_number": "417-269-1372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DETTEN",
        "first_name": "WILLIAM",
        "middle_name": "RUSSELL",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2012-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "R4P90",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "246778419",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS MO",
            "identifier": "5716",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shannon Elizabeth Derricks, ATC
• Mayra A Derrington, MA, LPLC
• Kathryne Rachelle Derrough, M.D.
• Neal Evan Desha, MED, LPC
• Indiana Desimone, LMSW
• Developmental Center of the Ozarks
• Developmental Center of the Ozarks
• Developmental Center of the Ozarks
• Developmental Center of the Ozarks
• Developmental Center of the Ozarks

• Family Medicine Physician in Springfield, MO
• Providers in Springfield, MO by specialty
• Family Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2012; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.