Individual provider Active NPI

John W Clouse, M.D.

  • Radiation Oncology Physician
  • Springfield, MO
National Provider Identifier
1144224569
Registry record updated Jan 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
R5B59 Issued in MO
Practice address
5057 S Glenhaven Ave
Springfield, MO 65804-7800
Phone
(417) 887-7914
NPI assigned
Jun 13, 2005
Last updated
Jan 11, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X R5B59 MO
Radiation Oncology Physician 2085R0001X R5B59 MO Primary

Addresses

Primary practice location

5057 S Glenhaven Ave
Springfield, MO 65804-7800

Mailing address

5057 S Glenhaven Ave
Springfield, MO 65804-7800

Other identifiers 2

IdentifierTypeStateIssuer
201574423MedicaidMO
148380071OtherMOMEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Radiation Oncology of the Ozarks, Inc. Specialist Current Accepting new patients
Central Care PA Radiation Oncology Past Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

3850 S National Ave
Ste 100
Springfield, MO 65807
Phone (417) 269-6115

Interoperability endpoints

  • Direct secure messaging: john.clouse@cernerdirect.coxhealth.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1118620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673395200000",
    "number": "1144224569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5057 S GLENHAVEN AVE",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658047800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5057 S GLENHAVEN AVE",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658047800",
            "telephone_number": "417-887-7914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLOUSE",
        "first_name": "JOHN",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-13",
        "last_updated": "2023-01-11",
        "certification_date": "2023-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MO",
            "license": "R5B59",
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "MO",
            "license": "R5B59",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201574423",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "148380071",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.