Individual provider Active NPI

John Charles Mace, M.D.

  • Neurological Surgery Physician
  • Springfield, MO
National Provider Identifier
1114971264
Registry record updated Sep 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
118061 Issued in MO
Practice address
3801 S National Ave
West Tower, Suite 700
Springfield, MO 65807-5210
Phone
(417) 885-3888
Fax
(417) 881-7638
NPI assigned
May 22, 2006
Last updated
Sep 30, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X E3602 AR
Neurological Surgery Physician 207T00000X 118061 MO Primary

Addresses

Primary practice location

3801 S National Ave
West Tower, Suite 700
Springfield, MO 65807-5210

Mailing address

PO Box 9434
Springfield, MO 65801-9434
Phone (417) 885-3888

Other identifiers 15

IdentifierTypeStateIssuer
5M988OtherARARKANSAS BC/BS
18942OtherMOCOX HEALTH PLANS
203985700MedicaidMO
5M988OtherARHEALTH ADVANTAGE
04040017000OtherMOQUAL CHOICE
0215049OtherWADEPARTMENT OF LABOR WA
119340OtherMOBLUE CROSS/CHOICE
0156395001OtherMOCIGNA HEALTHCARE
139629001MedicaidAR
4188130001OtherMOCIGNA MEDICARE
0602002OtherMOUNITED HEALTHCARE
412307OtherMOHEALTHLINK
5M988OtherARARKANSAS FIRST SOURCE
G93208OtherMOUSPS (W/C)
7623OtherMOCOX HEALTH PLANS UPI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR, MO2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20050407001345 AR Practitioner - Neurosurgery 3072564236 Reassigns benefits to 3 organizations
I20101015000668 MO Practitioner - Neurosurgery 3072564236 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
University of Missouri, Columbia School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

121 Cahill Rd
Suite 205
Branson, MO 65616-1911
Phone (417) 885-3888

3801 S National Ave
Suite 700
Springfield, MO 65807-5210
Phone (417) 885-3888

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion169
Laminectomy or laminotomy (partial removal of spine bones)33

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
118061MOMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Springfield Neurological Institute, L.L.C. Neurological Surgery CurrentSince Mar 1, 2001 Accepting new patients
Washington Regional Medical System Neurological Surgery CurrentSince Apr 12, 2013 Accepting new patients
Washington Regional Medical System CurrentSince Apr 12, 2013 Accepting new patients
Springfield Neurological and Spine Institute Neurological Surgery CurrentSince Jan 1, 2011 Accepting new patients
Springfield Neurological Institute, L.L.C. Neurological Surgery CurrentSince Mar 1, 2001 Accepting new patients
Springfield Neurological and Spine Institute Neurological Surgery CurrentSince Jan 1, 2011 Accepting new patients
Springfield Neurological and Spine Institute Neurological Surgery Current Accepting new patients
Springfield Neurological and Spine Institute Neurological Surgery CurrentSince Feb 28, 2011 Accepting new patients
Springfield Neurological and Spine Institute Neurological Surgery Past Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

3336 N Futrall Dr
Fayetteville, AR 72703
Phone (479) 444-8827

3 Medical Plz
Mountain Home, AR 72653
Phone (870) 424-3400

607 N Town
Mountain Home, AR 72653
Phone (870) 424-7033

121 Cahill Rd
Ste 205
Branson, MO 65616
Phone (417) 348-8253

1050 W 10th St
Ste 350
Rolla, MO 65401
Phone (573) 426-6239

1411 E Primrose St
Ste C
Springfield, MO 65804
Phone (417) 882-1207

2900 S National Ave
Springfield, MO 65804
Phone (417) 269-1499

2900 S National Ave
Ste 500
Springfield, MO 65804

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

3801 S National Ave
Ste 700
Springfield, MO 65807
Phone (417) 882-1207

Interoperability endpoints

  • Direct secure messaging: j.mace@cernerdirect.coxhealth.com

Organizations & group practices 11

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 4

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

NPI Registry JSON

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

{
    "created_epoch": "1148256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632960000000",
    "number": "1114971264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9434",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658019434",
            "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": "3801 S NATIONAL AVE",
            "address_2": "WEST TOWER, SUITE 700",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658075210",
            "telephone_number": "417-885-3888",
            "fax_number": "417-881-7638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACE",
        "first_name": "JOHN",
        "middle_name": "CHARLES",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-22",
        "last_updated": "2021-09-30",
        "certification_date": "2021-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "AR",
            "license": "E3602",
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "MO",
            "license": "118061",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARKANSAS BC/BS",
            "identifier": "5M988",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COX HEALTH PLANS",
            "identifier": "18942",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "203985700",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH ADVANTAGE",
            "identifier": "5M988",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "QUAL CHOICE",
            "identifier": "04040017000",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPARTMENT OF LABOR WA",
            "identifier": "0215049",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/CHOICE",
            "identifier": "119340",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA HEALTHCARE",
            "identifier": "0156395001",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "139629001",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA MEDICARE",
            "identifier": "4188130001",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "0602002",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "412307",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARKANSAS FIRST SOURCE",
            "identifier": "5M988",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "USPS (W/C)",
            "identifier": "G93208",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COX HEALTH PLANS UPI",
            "identifier": "7623",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MO

Sources for this page

Verify at the official NPI Registry.