NPIMap

Individual provider Active NPI

Tyler Gammon, DO

  • Internal Medicine Physician
  • Springfield, MO
National Provider Identifier
1124607858
Registry record updated Apr 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2024024463 Issued in MO
Practice address
3801 S National Ave Ste 1122
Springfield, MO 65807-6090
Phone
(417) 269-7728
Fax
(417) 269-7729
NPI assigned
Apr 8, 2021
Last updated
Apr 10, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 10, 2026

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 2024024463 MO Primary

Addresses

Primary practice location

3801 S National Ave Ste 1122
Springfield, MO 65807-6090

Mailing address

PO Box 505673
Saint Louis, MO 63150-5673
Phone (417) 730-6430

Other practice location 1

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

Other practice location 2

525 Branson Landing Blvd Ste 201A
Branson, MO 65616-2052
Phone (417) 335-7000

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
I20240729002295 MO Practitioner - Internal Medicine 6608312459 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sgoh Acquisition IncGroup PAC ID 5092616276, 95 clinicians
Lester E Cox Medical CentersGroup PAC ID 5799787784, 240 clinicians

Practice addresses (Care Compare)

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

13852 US Hwy 160
Forsyth, MO 65653-5156
Phone (417) 546-3500

3801 S National Ave
Springfield, MO 65807-5210
Phone (417) 269-7820

3801 S National Ave
Springfield, MO 65807-6090
Phone (417) 269-7728

525 Branson Landing Blvd
Branson, MO 65616-2052
Phone (417) 335-7128

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2024024463MOMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lester E Cox Medical Centers CurrentSince Jul 26, 2024 Accepting new patients
Skaggs Community Hospital Association CurrentSince Feb 1, 2026 Accepting new patients
Skaggs Community Hospital Association CurrentSince Feb 1, 2026 Accepting new patients
Lester E Cox Medical Centers CurrentSince Jul 26, 2024 Accepting new patients
Lester E Cox Medical Centers Past Accepting new patients
N & R of Brookhaven LLC Past Accepting new patients
N & R of Willard LLC Past Accepting new patients

Locations

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

3801 S National Ave
Ste 1122
Springfield, MO 65807

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 7

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": "1617840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775779200000",
    "number": "1124607858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 505673",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631505673",
            "telephone_number": "417-730-6430",
            "fax_number": "417-269-7567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 S NATIONAL AVE STE 1122",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658076090",
            "telephone_number": "417-269-7728",
            "fax_number": "417-269-7729"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 S Main St",
            "address_purpose": "LOCATION",
            "city": "Rogersville",
            "state": "MO",
            "postal_code": "657429357",
            "country_code": "US",
            "telephone_number": "417-753-9404",
            "fax_number": "417-753-9137",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "525 Branson Landing Blvd Ste 201A",
            "address_purpose": "LOCATION",
            "city": "Branson",
            "state": "MO",
            "postal_code": "656162052",
            "country_code": "US",
            "telephone_number": "417-335-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GAMMON",
        "first_name": "TYLER",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-04-08",
        "last_updated": "2026-04-10",
        "certification_date": "2026-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2024024463",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MO

Sources for this page

Verify at the official NPI Registry.