Organization Active NPI

Physicians for Breast Health, L.L.C.

  • Diagnostic Radiology Physician
  • Springfield, MO
National Provider Identifier
1063748929
Registry record updated Oct 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
PHYSICIANS FOR BREAST HEALTH, L.L.C.
Practice address
3850 S National Ave
Suite 300
Springfield, MO 65807-5287
Phone
(417) 269-6170
Fax
(417) 269-6992
NPI assigned
Oct 28, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2021

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

Authorized official

Name
Dr. Mark T. Barrett, M.D.NPI 1447415203
Title
Managing Member
Phone
(417) 269-6170

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X Primary

Addresses

Primary practice location

3850 S National Ave
Suite 300
Springfield, MO 65807-5287

Mailing address

PO Box 3262
Springfield, MO 65808-3262
Phone (417) 885-3888

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100123000017 MO Part B Supplier - Clinic/Group Practice 2062554462 Receives reassigned benefits from 7 practitioners
Practice locations: Springfield, MO; Monett, MO; Ozark, MO; Branson, MO; Lamar, MO

National Provider Directory

National Provider Directory

Locations

3901 S Fremont Ave
Springfield, MO 65804
Phone (417) 269-1182

3525 E Battlefield St
Springfield, MO 65809
Phone (417) 269-0065

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1256688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633305600000",
    "number": "1063748929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3262",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658083262",
            "telephone_number": "417-885-3888",
            "fax_number": "417-881-7638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3850 S NATIONAL AVE",
            "address_2": "SUITE 300",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658075287",
            "telephone_number": "417-269-6170",
            "fax_number": "417-269-6992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIANS FOR BREAST HEALTH, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-28",
        "last_updated": "2021-10-04",
        "certification_date": "2021-10-04",
        "status": "A",
        "authorized_official_last_name": "BARRETT",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "T.",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "417-269-6170",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.