Active NPI
William Lewis McKay, DO
- Family Medicine Physician
- Mount Vernon, MO
National Provider Identifier
1265417331
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- R5G53
- Practice address
- 108 S Hickory St
Mount Vernon, MO 65712-1407 - Phone
- (417) 466-4110
- Fax
- (417) 466-4255
- NPI assigned
- Dec 13, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | R5G53 | MO | Primary |
Addresses
Primary practice location
108 S Hickory St
Mount Vernon, MO 65712-1407
Mailing address
108 S Hickory St
Mount Vernon, MO 65712-1407
Phone (417) 466-4110
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 242356210 | Medicaid | MO | |
| 080033246 | Other | RR MEDICARE | |
| 1265417331 | Medicaid | MO |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Oklahoma State University College of Osteopathic Medicine, 1983
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
327 E Airport Dr
Carthage, MO 64836-3402
Phone (417) 237-0604
Hospital & facility affiliations
- Good Shepherd Hospice of Springfield, LLC
- Ozarks Community Hospital of Gravette
- Freeman Health System - Freeman West
- Cox Medical Centers
- Lawrence County Manor
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R5G53 | MO | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Primrose Nephrology, Inc. | Current | Accepting new patients | |
| Ozarks Medical Center | Family Medicine | Past | Accepting new patients |
Locations
1540 E Evergreen St
Springfield, MO 65803
Phone (417) 823-2900
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 and National Provider Directory roles.
-
- Clinic/Center
- Springfield, MO
- NPI 1114924768
-
- Specialist
- Springfield, MO
- NPI 1225163116
Hospital & facility affiliations 8
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Webb City, MO
- NPI 1114394228
Hospital
-
- General Acute Care Hospital
- Joplin, MO
- NPI 1265546048
-
- Community Based Hospice Care Agency
- Springfield, MO
- NPI 1720255284
-
- Skilled Nursing Facility
- Mount Vernon, MO
- NPI 1104887561
Nursing home
-
- General Acute Care Hospital
- Springfield, MO
- NPI 1093740128
-
- Critical Access Hospital
- Gravette, AR
- NPI 1568643005
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1134432000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1660867200000",
"number": "1265417331",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "108 S HICKORY ST",
"city": "MOUNT VERNON",
"state": "MO",
"postal_code": "657121407",
"telephone_number": "417-466-4110",
"fax_number": "417-466-4255"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "108 S HICKORY ST",
"city": "MOUNT VERNON",
"state": "MO",
"postal_code": "657121407",
"telephone_number": "417-466-4110",
"fax_number": "417-466-4255"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCKAY",
"first_name": "WILLIAM",
"middle_name": "LEWIS",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-13",
"last_updated": "2022-08-19",
"certification_date": "2022-08-17",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MO",
"license": "R5G53",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "242356210",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "080033246",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1265417331",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mount Vernon, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.