Druery J Dixon, M.D.
Individual provider Active NPI Family Medicine Physician · West Plains, MO
NPI 1205948247 · NPPES record last updated Sep 11, 2012
Key facts
- NPI
- 1205948247
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- R8G07 (MO)
- Practice address
- 181 N Kentucky Ave
Suite 100
West Plains, MO 65775-2089 - Phone
- (417) 257-5911
- Fax
- (417) 257-5913
- NPI assigned
- Aug 31, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 22
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Other, 1984
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Ozarks Medical Center
Servants Heart Healthcare, LLC
Practice addresses (Care Compare)
1100 N Kentucky Ave
West Plains, MO 65775-2029
311 Pine St
West Plains, MO 65775-2533
Phone (417) 221-6421
500 E 19TH St
Mountain Grove, MO 65711-1114
Phone (417) 926-6563
9104 State Hwy 19
Winona, MO 65588-8389
Phone (573) 325-4237
Hospital & facility affiliations
- Ozarks Healthcare
Merit-based Incentive Payment System (MIPS)
- Final score
- 88.96 of 100
- Quality
- 78.58
- Promoting interoperability
- 99
- Improvement activities
- 40
- Cost
- 77.82
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 |
|---|---|---|---|---|
| I20101008000987 | MO | Practitioner - Family Practice | 0840241774 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E4127 | AR | MD | Family Medicine Physician |
| R8G07 | MO | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ozarks Medical Center | Current |
Accepting new patients | |
| Ozarks Medical Center | Family Medicine | Current |
Accepting new patients |
| Ozarks Medical Center | Family Medicine | Past | Accepting new patients |
| Caddoes Emergency Physicians LLC | Past |
Accepting new patients | |
| West Plains Family Clinic Inc. | Family Medicine | Past | Accepting new patients |
| Triage Emergency Physicians | Past | Accepting new patients | |
| Gibson Community Hospital Association | Past | Accepting new patients |
Locations
225 E Jackson Ave
Jonesboro, AR 72401
Phone (870) 207-1630
225 E Washington Ave
Jonesboro, AR 72401
Phone (870) 207-1630
2801 Medical Center Dr
Pocahontas, AR 72455
Phone (870) 892-6000
220 N Elm St
Mountain View, MO 65548
Phone (417) 296-6563
1108 Alaska St
West Plains, MO 65775
Phone (417) 256-7137
1307 Porter Wagoner Blvd
West Plains, MO 65775
Phone (417) 255-8645
1100 N Kentucky Ave
West Plains, MO 65775
Phone (417) 257-5959
181 N Kentucky Ave
Ste 100
West Plains, MO 65775
Phone (417) 257-5911
311 Pine St
West Plains, MO 65775
Phone (417) 221-6421
9104 State Highway 19
Winona, MO 65588
Phone (573) 325-4237
Interoperability endpoints
- druerydixon@omcmo.allscriptsdirect.net
- dr.dixon@mhccaremail.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | E4127 | AR | |
| Family Medicine Physician | 207Q00000X | R8G07 | MO | Yes |
Addresses
Primary practice location
181 N Kentucky Ave
Suite 100
West Plains, MO 65775-2089
Mailing address
181 N Kentucky Ave
Suite 100
West Plains, MO 65775-2089
Phone (417) 257-5911
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 16390 | Other | MO | BCBS PROVIDER NUMBER |
| 202386926 | Medicaid | MO | |
| 121380001 | Other | AR | ARKANSAS MEDICAID |
Other providers in West Plains, MO
- Shaun Deshazo
- Dialysis Clinic Inc.
- Jean Ann Dickson
- Jonathan Dillinger
- Skylar Divine
- Doctors Urgent Care of West Plains, LLC
- Doctors Urgent Care, PC
- Ronald L Dorton
- Melanie Dotson
- Robert Dale Dowdy
All providers in West Plains, MO · Family 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 Sep 11, 2012. 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.