NPIMap

Individual provider Active NPI

Xujun Wu, MD

  • Gastroenterology Physician
  • Joplin, MO
National Provider Identifier
1235117425
Registry record updated Jun 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
2006024391 Issued in MO
Practice address
2817 MC Clelland Blvd
Suite 215
Joplin, MO 64804-1629
Phone
(417) 206-4928
Fax
(417) 206-4734
NPI assigned
Jan 6, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 19, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 2006024391 MO Primary

Addresses

Primary practice location

2817 MC Clelland Blvd
Suite 215
Joplin, MO 64804-1629

Mailing address

2817 MC Clelland Blvd
Suite 215
Joplin, MO 64804-1629
Phone (417) 206-4928

Other identifiers 6

IdentifierTypeStateIssuer
200092220AMedicaidOK
201431608MedicaidMO
200092230AMedicaidOK
200400660AMedicaidKS
2514363MedicaidOH
2006024391OtherMOSTATE OF MO LICENSE

Other names 1

  • John Wu Other 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
I20061114000557 MO Practitioner - Gastroenterology 3375517188 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic Joplin LLCGroup PAC ID 0547300196, 288 clinicians

Practice addresses (Care Compare)

3125 Dr Russell Smith Way
Carthage, MO 64836-7402
Phone (417) 358-8121

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy254
Upper gastrointestinal (GI) endoscopy for acid reflux636

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Joplin LLC CurrentSince Nov 1, 2009 Accepting new patients
Mercy Clinic Joplin LLC CurrentSince Nov 1, 2009 Accepting new patients
Gastroenterology of Canton Endoscopy Center Inc Past Accepting new patients
Gastroenterology of Canton Inc Gastroenterology Past Accepting new patients
Sjmgroup Past Accepting new patients

Locations

3125 Dr Russell Smith Way
Carthage, MO 64836
Phone (417) 358-8121

94 Main St
Cassville, MO 65625
Phone (417) 782-7722

2817 Mc Clelland Blvd
Ste 215
Joplin, MO 64804
Phone (417) 206-4928

100 Mercy Way
Ste 580
Joplin, MO 64804
Phone (417) 556-8455

100 Mercy Way
Joplin, MO 64804
Phone (417) 556-2300

3126 S Jackson Ave
Joplin, MO 64804
Phone (417) 782-1600

Interoperability endpoints

  • Direct secure messaging: xwu200179@directc.mercy.net
  • Direct secure messaging: xwu190722@directb.mercy.net

Organizations & group practices 5

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 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1136505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276905600000",
    "number": "1235117425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2817 MC CLELLAND BLVD",
            "address_2": "SUITE 215",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648041629",
            "telephone_number": "417-206-4928",
            "fax_number": "417-206-4734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2817 MC CLELLAND BLVD",
            "address_2": "SUITE 215",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648041629",
            "telephone_number": "417-206-4928",
            "fax_number": "417-206-4734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WU",
        "first_name": "XUJUN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-06",
        "last_updated": "2010-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MO",
            "license": "2006024391",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200092220A",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201431608",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200092230A",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200400660A",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2514363",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF MO LICENSE",
            "identifier": "2006024391",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOHN",
            "last_name": "WU",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Joplin, MO

Sources for this page

Verify at the official NPI Registry.