NPIMap

Individual provider Active NPI

Edgar M. Conrad IV, D.O.

  • Internal Medicine Physician
  • Joplin, MO
National Provider Identifier
1124055074
Registry record updated Aug 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
107748 Issued in 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
Last updated
Aug 10, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 107748 MO Primary

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 5

IdentifierTypeStateIssuer
100235930CMedicaidKS
100196580AMedicaidOK
3774OtherMOANTHEM
110203265OtherRR MEDICARE
248016636MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050510000819 MO Practitioner - Internal MedicinePractitioner - Emergency Medicine 0042250920 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Curana Health of Missouri-Kansas LLCGroup PAC ID 4789716531, 143 clinicians
CH Specialty Services Mo LLCGroup PAC ID 0345614459, 108 clinicians

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

Merit-based Incentive Payment System (MIPS)

Final score
23.26 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
77.54

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
107748MOMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
CH Specialty Services Mo LLC Internal Medicine CurrentSince Jun 3, 2025 Accepting new patients
Curana Health of Missouri-Kansas LLC CurrentSince Jun 3, 2025 Accepting new patients
Edgar M Conrad IV, LLC Internal Medicine CurrentSince May 19, 2008 Accepting new patients
Aspire Senior Living Joplin LLC Past Accepting new patients
Northport Health Services of Missouri, LLC Past Accepting new patients
NHC Healthcare-Joplin LLC Past Accepting new patients
Aspire Senior Living Webb City LLC Past Accepting new patients
Ozarks Medical Center Past Accepting new patients
Northport Health Services of Missouri, 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

Organizations & group practices 9

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 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312934400000",
    "number": "1124055074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2727 E. 32ND ST",
            "address_2": "STE 1",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "64804",
            "telephone_number": "417-782-3292",
            "fax_number": "417-782-4024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2727 E. 32ND ST",
            "address_2": "STE 1",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "64804",
            "telephone_number": "417-782-3292",
            "fax_number": "417-782-4024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONRAD",
        "first_name": "EDGAR",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "name_suffix": "IV",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-27",
        "last_updated": "2011-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "107748",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100235930C",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100196580A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "3774",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "110203265",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "248016636",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Joplin, MO

Sources for this page

Verify at the official NPI Registry.