Edgar M. Conrad IV, D.O.
Individual provider Active NPI Internal Medicine Physician · Joplin, MO
NPI 1124055074 · NPPES record last updated Aug 10, 2011
Key facts
- NPI
- 1124055074
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 107748 (MO)
- Practice address
- 2727 E. 32ND St
Ste 1
Joplin, MO 64804 - Phone
- (417) 782-3292
- Fax
- (417) 782-4024
- NPI assigned
- Jun 27, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 9
Hospital & facility affiliations 13
Medicare Care Compare profile
- Specialty
- Internal Medicine
- Education
- Other, 1990
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Curana Health of Missouri-Kansas LLC
CH Specialty Services Mo LLC
Practice addresses (Care Compare)
2727 E 32ND St
Suite 1
Joplin, MO 64804-3147
Phone (417) 782-3292
2885 Technology Dr
Lake St Louis, MO 63367-4123
Phone (337) 991-9276
400 SW Longview Blvd
Suite 200
Lees Summit, MO 64081-2116
Phone (337) 991-9276
Hospital & facility affiliations
- Phoenix Home Care and Hospice
- Hospice Compassus-Joplin
- Good Shepherd Hospice of Springfield, LLC
- Integrity Home Care + Hospice
- Freeman Health System - Freeman West
- Freeman Neosho Hospital
- NHC Healthcare, Joplin
- Aspire Senior Living Joplin
- Aspire Senior Living Webb City
Merit-based Incentive Payment System (MIPS)
- Final score
- 23.26 of 100
- Quality
- 0
- Improvement activities
- 0
- Cost
- 77.54
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050510000819 | MO | Practitioner - Internal Medicine |
0042250920 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 107748 | MO | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| CH Specialty Services Mo LLC | Internal Medicine | Current |
Accepting new patients |
| Curana Health of Missouri-Kansas LLC | Current |
Accepting new patients | |
| Edgar M Conrad IV, LLC | Internal Medicine | Current |
Accepting new patients |
| NHC Healthcare-Joplin LLC | Past | Accepting new patients | |
| Northport Health Services of Missouri, LLC | Past | Accepting new patients | |
| Aspire Senior Living Joplin LLC | Past | Accepting new patients | |
| Northport Health Services of Missouri, LLC | Past | Accepting new patients | |
| Ozarks Medical Center | Past | Accepting new patients | |
| Aspire Senior Living Webb City LLC | Past | Accepting new patients |
Locations
403 W Main St
Cole Camp, MO 65325
Phone (660) 668-4515
2727 E 32nd St
Ste 1
Joplin, MO 64804
Phone (417) 782-3292
2323 E 63rd St
Kansas City, MO 64130
Phone (816) 444-8161
2885 Technology Dr
Lake St Louis, MO 63367
Phone (314) 259-1044
400 SW Longview Blvd
Ste 200
Lees Summit, MO 64081
Phone (816) 477-7200
11278 Schuetz Rd
Saint Louis, MO 63146
Phone (314) 991-4066
1101 W Clay Rd
Versailles, MO 65084
Phone (573) 378-5312
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 107748 | MO | Yes |
Addresses
Primary practice location
2727 E. 32ND St
Ste 1
Joplin, MO 64804
Mailing address
2727 E. 32ND St
Ste 1
Joplin, MO 64804
Phone (417) 782-3292
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100196580A | Medicaid | OK | |
| 110203265 | Other | RR MEDICARE | |
| 248016636 | Medicaid | MO | |
| 100235930C | Medicaid | KS | |
| 3774 | Other | MO | ANTHEM |
Other providers in Joplin, MO
- Compassionate Inner Awakenings Counseling, LLC
- Angela Cecile Comstock
- Lolita Gahum Concha
- Patrick Connell
- Christine E. Conner
- Nolan Robert Conrad
- Katie Cook
- Phyllis Irene Cook
- Jenny Lynn Cooper
- Leah Cooper
All providers in Joplin, MO · Internal Medicine Physician in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 10, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.