Tyler Gammon, DO
Individual provider Active NPI Internal Medicine Physician · Springfield, MO
NPI 1124607858 · NPPES record last updated Apr 10, 2026
Key facts
- NPI
- 1124607858
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 2024024463 (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
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 54
Hospital & facility affiliations 7
Medicare Care Compare profile
- Specialty
- Internal Medicine
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Sgoh Acquisition Inc
Skaggs Community Hospital Association
Lester E Cox Medical Centers
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
- Cox Medical Centers
- Cox Medical Center Branson
- Ozarks Community Hospital of Gravette
- Willard Care Center
- Brookhaven Nursing & Rehab
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 |
|---|---|---|---|---|
| I20240729002295 | MO | Practitioner - Internal Medicine | 6608312459 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lester E Cox Medical Centers | Current |
Accepting new patients | |
| Skaggs Community Hospital Association | Current |
Accepting new patients | |
| Skaggs Community Hospital Association | Current |
Accepting new patients | |
| Lester E Cox Medical Centers | Current |
Accepting new patients | |
| N & R of Brookhaven LLC | Past | Accepting new patients | |
| N & R of Willard LLC | Past | Accepting new patients | |
| Lester E Cox Medical Centers | 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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 2024024463 | MO | Yes |
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
525 Branson Landing Blvd Ste 201A
Branson, MO 65616-2052
Phone (417) 335-7000
Other practice location 2
101 S Main St
Rogersville, MO 65742-9357
Phone (417) 753-9404
Other providers in Springfield, MO
- Tyler M Gallion
- Stephen R Gallo
- Morgan Galloway
- Elizabeth Renee Gambill
- Dustin Gammon
- Erin Gamwell
- Jennifer L Ganaway
- Beverly Jo Gann
- Lea M Gannaway
- James Ganus
All providers in Springfield, 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 Apr 10, 2026. 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.