NPIMap

Organization Active NPI

Missouri Eye Institute of Joplin LLC

  • Ophthalmology Physician
  • Joplin, MO
National Provider Identifier
1285767889
Registry record updated Mar 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
MISSOURI EYE INSTITUTE OF JOPLIN LLC
Practice address
4500 East 32ND Street
Joplin, MO 64804-1512
Phone
(417) 626-8082
Fax
(417) 626-4393
NPI assigned
Mar 13, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2024

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

Authorized official

Name
Daniel R Osborn Jr., MDNPI 1093701211
Title
Owner
Phone
(417) 887-3900

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

4500 East 32ND Street
Joplin, MO 64804-1512

Mailing address

1531 East Bradford Parkway Ste 100
Springfield, MO 65804-6539
Phone (417) 887-3900

Other identifiers 3

IdentifierTypeStateIssuer
1285767889OtherMONPI
000015239OtherMOMEDICARE GROUP
DF7539OtherMORAILROAD MEDICARE GROUP

Other names 1

  • Missouri Eye Institute of Joplin LLC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, KS2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20070503000494 MO Part B Supplier - Clinic/Group Practice 4688770829 Receives reassigned benefits from 9 practitioners
Practice locations: Joplin, MO
O20110616000097 KS Part B Supplier - Clinic/Group Practice 4688770829 Receives reassigned benefits from 1 practitioner
Practice locations: Galena, KS

National Provider Directory

National Provider Directory

Locations

1531 E Bradford Pkwy
Ste 100
Springfield, MO 65804

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710892800000",
    "number": "1285767889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1531 EAST BRADFORD PARKWAY STE 100",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658046539",
            "telephone_number": "417-887-3900",
            "fax_number": "417-823-2894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 EAST 32ND STREET",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648041512",
            "telephone_number": "417-626-8082",
            "fax_number": "417-626-4393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSOURI EYE INSTITUTE OF JOPLIN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-13",
        "last_updated": "2024-03-20",
        "certification_date": "2024-03-18",
        "status": "A",
        "authorized_official_last_name": "OSBORN",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "417-887-3900",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1285767889",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "000015239",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE GROUP",
            "identifier": "DF7539",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Missouri Eye Institute of Joplin LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Missouri Eye Institute of Joplin LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Joplin, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.