Garry J Brown, DO
Individual provider Active NPI Radiation Oncology Physician · Bolivar, MO
NPI 1043366925 · NPPES record last updated Jan 12, 2021
Key facts
- NPI
- 1043366925
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Radiation Oncology Physician 2085R0001X
- License
- 2005041207 (MO)
- Practice address
- 1501 N Oakland Ave
Bolivar, MO 65613-3020 - Phone
- (417) 326-7200
- Fax
- (417) 326-7201
- NPI assigned
- Jan 25, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 6
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060206000126 | MO | Practitioner - Radiation Oncology | 0446202725 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
Practice roles (6 of 8)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Spencer Municipal Hospital | Current | Accepting new patients | |
| Ozarks Medical Center | Current |
Accepting new patients | |
| Ozarks Medical Center | Current |
Accepting new patients | |
| Northern Rockies Radiation Oncology Center LLC | Past | Accepting new patients | |
| Charleston Radiation Therapy Consultants PLLC | Radiation Oncology | Past | Accepting new patients |
| Central Care, PA | Radiation Oncology | Past |
Accepting new patients |
Locations
1200 1st Ave E
Spencer, IA 51301
Phone (712) 264-6164
8929 Parallel Pkwy
Ste G
Kansas City, KS 66112
Phone (913) 318-7821
1501 N Oakland Ave
Bolivar, MO 65613
Phone (417) 326-7200
1605 Martin Springs Dr
Ste 330
Rolla, MO 65401
Phone (573) 458-6379
2115 S Fremont Ave
Ste 3050
Springfield, MO 65804
Phone (417) 820-3905
2828 N National Ave
Springfield, MO 65803
Phone (417) 837-4000
1115 Alaska St
Ste 115A
West Plains, MO 65775
1100 N Kentucky Ave
West Plains, MO 65775
Phone (417) 257-5959
Networks
- IA HMO
- IA HMO C-SNP
Interoperability endpoints
- garry.brown@cccancer.ikm.direct-ci.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Radiation Oncology Physician | 2085R0001X | 2005041207 | MO | Yes |
Addresses
Primary practice location
1501 N Oakland Ave
Bolivar, MO 65613-3020
Mailing address
PO Box 256
Salina, KS 67402-0256
Phone (785) 823-0633
Other practice location 1
1401 W 12th Ave
Emporia, KS 66801-2570
Phone (620) 342-1117
Other practice location 2
8929 Parallel Pkwy Ste G
Kansas City, KS 66112-1689
Phone (913) 318-7821
Other practice location 3
730 Medical Center Dr
Newton, KS 67114-8778
Phone (316) 283-1141
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 20091105 | Medicaid | MO | |
| 146240006 | Other | MO | PTAN |
| 161641103 | Medicaid | AR | |
| 16701011 | Other | KS | MEDICARE |
| 200721240A | Medicaid | KS |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | garry.brown@cccancer.ikm.drect-ci.com | ||
| Direct Messaging Address | garry.brown@cccancer.ikm.drect-ci.com | ||
| Direct Messaging Address | garry.brown@cccancer.ikm.drect-ci.com | ||
| Direct Messaging Address | garry.brown@cccancer.ikm.drect-ci.com |
Other providers in Bolivar, MO
- Brian G Hackleman DC
- Brian G. Hackleman, D.C., L.L.C.
- Rebecca L. Briggs
- Carmen Broadbent
- Jason Brooks
- Ira Jason Brown
- Courtney Marie Brummel
- Susan Kay Buchen
- Samuel Christian Buesking
- Mark J Bult
All providers in Bolivar, MO · Radiation Oncology Physician in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 12, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.