NPIMap

Organization Active NPI

Cornerstone Medical, LLC

  • Internal Medicine Physician
  • Joplin, MO
National Provider Identifier
1104549948
Registry record updated Sep 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
CORNERSTONE MEDICAL, LLC
Practice address
2613 S Main St Ste D
Joplin, MO 64804-2678
Phone
(417) 624-8730
NPI assigned
Sep 26, 2022
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Joseph Kirk SheppardNPI 1083901821
Title
Ceo
Phone
(417) 379-1176

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

Practitioners 45

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

View all 45

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
26D2308989Cornerstone Medical LLC308 N Main St, Granby, MO 64844Certificate of waiverAug 6, 2026

Medicare participation

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

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
O20221018001701 MO Part B Supplier - Clinic/Group Practice 4284000183 Receives reassigned benefits from 9 practitioners
Practice locations: Granby, MO; Joplin, MO

National Provider Directory

National Provider Directory

Locations

308 N Main St
Granby, MO 64844
Phone (417) 553-7920

2702 Cunningham Ave
Ste A
Joplin, MO 64804
Phone (417) 553-7920

2702 Cunningham Ave
Joplin, MO 64804

Specialties & licenses 5

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary
Obesity Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RB0002X
Facial Plastic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207YS0123X
Otolaryngic Allergy PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207YX0602X

Addresses

NPPES NPI Registry

Primary practice location

2613 S Main St Ste D
Joplin, MO 64804-2678

Mailing address

2613 S Main St Ste D
Joplin, MO 64804-2678
Phone (417) 553-7920

Other practice location 1

308 N Main St
Granby, MO 64844-8357
Phone (417) 553-7920

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 25, 2025.

{
    "created_epoch": "1664150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758758400000",
    "number": "1104549948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2613 S MAIN ST STE D",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648042678",
            "telephone_number": "417-553-7920",
            "fax_number": "877-464-5922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2613 S MAIN ST STE D",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648042678",
            "telephone_number": "417-624-8730"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "308 N Main St",
            "address_purpose": "LOCATION",
            "city": "Granby",
            "state": "MO",
            "postal_code": "648448357",
            "country_code": "US",
            "telephone_number": "417-553-7920",
            "fax_number": "877-464-5922",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CORNERSTONE MEDICAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-26",
        "last_updated": "2025-09-25",
        "certification_date": "2025-09-25",
        "status": "A",
        "authorized_official_last_name": "SHEPPARD",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "KIRK",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "417-379-1176"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RB0002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Obesity Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207YS0123X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207YX0602X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology, Otolaryngic Allergy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Joplin, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.