Individual provider Active NPI

Patrick Edward Macmillan, D.O.

  • Family Medicine Physician
  • Rogersville, MO
National Provider Identifier
1073604690
Registry record updated Aug 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
R2H29 Issued in MO
Practice address
101 S Main St
Rogersville, MO 65742-9357
Phone
(417) 753-9404
Fax
(417) 753-9137
NPI assigned
Sep 27, 2006
Last updated
Aug 17, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 17, 2022

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 R2H29 MO Primary

Addresses

Primary practice location

101 S Main St
Rogersville, MO 65742-9357

Mailing address

101 S Main St
Rogersville, MO 65742-9357
Phone (417) 753-9404

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20081126000092 MO Practitioner - Family PracticePractitioner - General Practice 7214097906 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sgoh Acquisition IncGroup PAC ID 5092616276, 95 clinicians

Practice addresses (Care Compare)

101 S Main St
Rogersville, MO 65742-9357
Phone (417) 753-9404

106 S Hickory St
Mount Vernon, MO 65712-1407
Phone (417) 466-4110

108 S Hickory St
Mount Vernon, MO 65712-1407
Phone (417) 466-4110

543 W Hubble Dr
Marshfield, MO 65706-1532
Phone (417) 859-4878

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ozarks Medical Center Family Medicine Past Accepting new patients
Aria Vision Care, LLC Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660694400000",
    "number": "1073604690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 S MAIN ST",
            "city": "ROGERSVILLE",
            "state": "MO",
            "postal_code": "657429357",
            "telephone_number": "417-753-9404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 S MAIN ST",
            "city": "ROGERSVILLE",
            "state": "MO",
            "postal_code": "657429357",
            "telephone_number": "417-753-9404",
            "fax_number": "417-753-9137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACMILLAN",
        "first_name": "PATRICK",
        "middle_name": "EDWARD",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-27",
        "last_updated": "2022-08-17",
        "certification_date": "2022-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "R2H29",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rogersville, MO

Sources for this page

Verify at the official NPI Registry.