NPIMap

Individual provider Active NPI

Gregory V. Maynard, D.O.

  • Family Medicine Physician
  • Saint James, MO
National Provider Identifier
1063450187
Registry record updated Jun 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
113166 Issued in MO
Practice address
1000 N Jefferson St
Saint James, MO 65559-1078
Phone
(573) 265-8840
Fax
(573) 202-2474
NPI assigned
Jun 2, 2006
Last updated
Jun 11, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2026

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 113166 MO Primary

Addresses

Primary practice location

1000 N Jefferson St
Saint James, MO 65559-1078

Mailing address

1050 W 10TH St
Rolla, MO 65401-2905
Phone (573) 364-9000

Other practice location 1

404 E Rolla Rd
Salem, MO 65560-1563
Phone (573) 729-6225

Other practice location 2

1000 W 10th St
Rolla, MO 65401-2905
Phone (573) 458-8899

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
I20050518000899 MO Practitioner - Family Practice 1254372386 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Phelps County Regional Medical CenterGroup PAC ID 2860391158, shared by 7 NPIs, 111 clinicians
Mercy Clinic Springfield CommunitiesGroup PAC ID 7416865845, shared by 26 NPIs, 1,121 clinicians

Practice addresses (Care Compare)

1000 N Jefferson St
Saint James, MO 65559-1078
Phone (573) 265-8840

107 W Eldon St
MC Family Medicine St James
Saint James, MO 65559-1903
Phone (573) 265-1818

1605 Martin Springs Dr
Rolla, MO 65401-2980

404 W Rolla Rd
MC Family Medicine Salem
Salem, MO 65560-1233
Phone (573) 729-6225

518 Pine St
Steelville, MO 65565-6041
Phone (573) 775-5838

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
113166MOMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Springfield Communities Family Medicine CurrentSince May 22, 2006 Accepting new patients
Mercy Clinic Springfield Communities Family Medicine CurrentSince Jan 28, 2018 Accepting new patients
Mercy Clinic Springfield Communities Family Medicine CurrentSince May 22, 2006 Accepting new patients
Texas County Memorial Hospital Past Accepting new patients
Kerr Healthcare Services LLC PastSince Jul 7, 2007 Accepting new patients
Ozarks Medical Center Family Medicine Past Accepting new patients

Locations

1333 S Sam Houston Blvd
Houston, MO 65483
Phone (417) 967-1252

1000 W 10th St
Rolla, MO 65401
Phone (573) 364-9000

1100 W 10th St
Ste 155
Rolla, MO 65401
Phone (314) 364-2227

1605 Martin Springs Dr
Rolla, MO 65401
Phone (573) 458-6379

1605 Martin Springs Dr
Ste 330
Rolla, MO 65401
Phone (573) 458-6379

107 W Eldon St
Saint James, MO 65559
Phone (573) 265-1818

404 W Rolla Rd
Salem, MO 65560
Phone (573) 729-6225

2115 S Fremont Ave
Ste 3050
Springfield, MO 65804
Phone (417) 820-3905

3801 S National Ave
Springfield, MO 65807
Phone (417) 269-4056

620 S Glenstone Ave
Springfield, MO 65802
Phone (417) 581-8170

518 Pine St
Steelville, MO 65565
Phone (573) 775-5838

Interoperability endpoints

  • Direct secure messaging: gmaynard1237@directb.mercy.net
  • Direct secure messaging: gmaynard18766@directc.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
Phelps Health Home Health & HospiceRolla, MO, CCN 267555 Home health agency Other May 1, 2022
Phelps Health Home Health & HospiceRolla, MO, CCN 261583 Hospice W-2 Managing Employee May 1, 2022

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 6

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 20

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

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781136000000",
    "number": "1063450187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 W 10TH ST",
            "city": "ROLLA",
            "state": "MO",
            "postal_code": "654012905",
            "telephone_number": "573-364-9000",
            "fax_number": "573-426-2108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 N JEFFERSON ST",
            "city": "SAINT JAMES",
            "state": "MO",
            "postal_code": "655591078",
            "telephone_number": "573-265-8840",
            "fax_number": "573-202-2474"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "404 E Rolla Rd",
            "address_purpose": "LOCATION",
            "city": "Salem",
            "state": "MO",
            "postal_code": "655601563",
            "country_code": "US",
            "telephone_number": "573-729-6225",
            "fax_number": "573-729-7258",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1000 W 10th St",
            "address_purpose": "LOCATION",
            "city": "Rolla",
            "state": "MO",
            "postal_code": "654012905",
            "country_code": "US",
            "telephone_number": "573-458-8899",
            "fax_number": "573-341-5611",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAYNARD",
        "first_name": "GREGORY",
        "middle_name": "V.",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-02",
        "last_updated": "2026-06-11",
        "certification_date": "2026-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "113166",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint James, MO

Sources for this page

Verify at the official NPI Registry.