Individual provider Active NPI

Richard T Shimizu, MD

  • Internal Medicine Physician
  • Springfield, MO
National Provider Identifier
1164466645
Registry record updated Jul 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
115271 Issued in MO
Practice address
1001 E Primrose St
Springfield, MO 65807-5155
Phone
(417) 875-3000
Fax
(417) 875-3051
NPI assigned
Jun 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2012

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 115271 MO Primary

Addresses

Primary practice location

1001 E Primrose St
Springfield, MO 65807-5155

Mailing address

PO Box 9007
Springfield, MO 65808-9007
Phone (417) 875-3000

Other identifiers 2

IdentifierTypeStateIssuer
114572OtherBLUE CROSS/BLUE SHIELD
203834403MedicaidMO

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050817000087 MO Practitioner - Internal Medicine 7517997851 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Virginia School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lester E Cox Medical CentersGroup PAC ID 8628092897, 243 clinicians

Practice addresses (Care Compare)

1001 E Primrose
Ferrell Duncan Clinic
Springfield, MO 65807-5155
Phone (417) 875-3000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.25 of 100Reported as group
Quality
64.73
Promoting interoperability
100
Improvement activities
40
Cost
76.1

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
115271MOMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lester E Cox Medical Centers CurrentSince Jan 1, 2006 Accepting new patients
Lester E Cox Medical Centers Past Accepting new patients
Ozarks Medical Center Past Accepting new patients
Ferrell Duncan Clinic, Inc Past Accepting new patients

Locations

1500 N Oakland Ave
Bolivar, MO 65613
Phone (417) 326-6000

1001 E Primrose St
Ste 200
Springfield, MO 65807
Phone (417) 875-3275

3525 S National Ave
Ste 101
Springfield, MO 65807
Phone (417) 269-9950

1001 E Primrose St
Springfield, MO 65807
Phone (417) 875-3434

1423 N Jefferson Ave
Springfield, MO 65802
Phone (417) 269-6583

3800 S National Ave
Ste 540
Springfield, MO 65807
Phone (417) 269-6262

Interoperability endpoints

  • Direct secure messaging: richard.shimizu@cernerdirect.coxhealth.com

Organizations & group practices 4

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 4

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": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341446400000",
    "number": "1164466645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9007",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658089007",
            "telephone_number": "417-875-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 E PRIMROSE ST",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658075155",
            "telephone_number": "417-875-3000",
            "fax_number": "417-875-3051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIMIZU",
        "first_name": "RICHARD",
        "middle_name": "T",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-15",
        "last_updated": "2012-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "115271",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "114572",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "203834403",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MO

Sources for this page

Verify at the official NPI Registry.