NPIMap

Individual provider Active NPI

Deborah Lou Sheehan, DO

  • Family Medicine Physician
  • Willow Springs, MO
National Provider Identifier
1164410353
Registry record updated Jul 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2009010253 Issued in MO
Practice address
1202 E Main St
Willow Springs, MO 65793-3588
Phone
(417) 469-1820
Fax
(417) 469-5280
NPI assigned
Oct 11, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 3619 OK
Family Medicine Physician 207Q00000X 2009010253 MO Primary

Addresses

Primary practice location

1202 E Main St
Willow Springs, MO 65793-3588

Mailing address

1202 E Main St
Willow Springs, MO 65793-3588
Phone (417) 469-1820

Other identifiers 6

IdentifierTypeStateIssuer
1164410353MedicaidMO
500522075OtherOKMEDICARE GROUP PIN
P00724816OtherMORAILROAD MEDICARE
100131490BMedicaidOK
177582003MedicaidAR
431560263OtherTRICARE WEST

Other names 1

  • Deborah Lou Winter Former name

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
I20090626000226 MO Practitioner - Family Practice 9032260336 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Oklahoma State University College of Osteopathic Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Clinic Springfield CommunitiesGroup PAC ID 7416865845, shared by 26 NPIs, 1,121 clinicians

Practice addresses (Care Compare)

1202 E Main St
MC Family Medicine Willow Springs
Willow Springs, MO 65793-3588
Phone (417) 469-1820

1605 Martin Springs Dr
Rolla, MO 65401-2980

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2009010253MOMDFamily Medicine Physician
3619OKMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Springfield Communities Family Medicine CurrentSince Jun 8, 2009 Accepting new patients
Mercy St. Francis Hospital Current Accepting new patients
Mercy Clinic Springfield Communities Family Medicine CurrentSince Jun 8, 2009 Accepting new patients
Mercy Clinic Springfield Communities Family Medicine CurrentSince Feb 13, 2018 Accepting new patients
Mercy St. Francis Hospital CurrentSince Jun 15, 2009 Accepting new patients
Ozarks Medical Center Family Medicine Past Accepting new patients
Claremore Physicians LLC Past Accepting new patients
Kabul Nursing Homes Inc Past Accepting new patients

Locations

100 W US Highway 60
Mountain View, MO 65548
Phone (417) 934-7000

1605 Martin Springs Dr
Rolla, MO 65401
Phone (573) 458-6379

1605 Martin Springs Dr
Ste 330
Rolla, MO 65401
Phone (573) 458-6379

2115 S Fremont Ave
Ste 3050
Springfield, MO 65804
Phone (417) 820-3905

1202 E Main St
Willow Springs, MO 65793
Phone (417) 293-7184

Interoperability endpoints

  • Direct secure messaging: dsheehan77304@directc.mercy.net
  • Direct secure messaging: dsheehan67265@directb.mercy.net

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 and National Provider Directory roles.

Hospital & facility affiliations 20

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

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1128988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564358400000",
    "number": "1164410353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1202 E MAIN ST",
            "city": "WILLOW SPRINGS",
            "state": "MO",
            "postal_code": "657933588",
            "telephone_number": "417-469-1820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1202 E MAIN ST",
            "city": "WILLOW SPRINGS",
            "state": "MO",
            "postal_code": "657933588",
            "telephone_number": "417-469-1820",
            "fax_number": "417-469-5280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEEHAN",
        "first_name": "DEBORAH",
        "middle_name": "LOU",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-11",
        "last_updated": "2019-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "3619",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2009010253",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1164410353",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PIN",
            "identifier": "500522075",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00724816",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100131490B",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "177582003",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE WEST",
            "identifier": "431560263",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEBORAH",
            "last_name": "WINTER",
            "middle_name": "LOU",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Willow Springs, MO

Sources for this page

Verify at the official NPI Registry.