NPIMap

Individual provider Active NPI

Jeffrey L Dryden, D.O.

  • Internal Medicine Physician
  • West Plains, MO
National Provider Identifier
1316923956
Registry record updated Nov 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
R5D34 Issued in MO
Practice address
1100 N Kentucky Ave
West Plains, MO 65775-2029
Phone
(417) 256-9111
Fax
(417) 257-5999
NPI assigned
Dec 15, 2005
Last updated
Nov 12, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X R5D34 MO Primary
Hospitalist Physician 208M00000X R5D34 MO

Addresses

Primary practice location

1100 N Kentucky Ave
West Plains, MO 65775-2029

Mailing address

P.O. Box 1100
West Plains, MO 65775-1100
Phone (417) 257-5800

Other identifiers 2

IdentifierTypeStateIssuer
125592003MedicaidAR
1316923956MedicaidMO

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
I20101028000789 MO Practitioner - Internal MedicinePractitioner - Hospitalist 5991613846 Reassigns benefits to 8 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hospitalist
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carroll County Memorial HospitalGroup PAC ID 2860485638, 64 clinicians
Hni Medical Services of Missouri LLCGroup PAC ID 6002214343, 10 clinicians
Excelsior Springs City HospitalGroup PAC ID 7315847209, shared by 5 NPIs, 39 clinicians

Practice addresses (Care Compare)

1502 N Jefferson St
Carrollton, MO 64633-1948
Phone (660) 542-1695

1630 E Primrose St
Springfield, MO 65804-7929
Phone (717) 972-1100

1700 Rainbow Blvd
Excelsior Springs, MO 64024-1182
Phone (816) 630-6081

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R5D34MOMDInternal Medicine Physician
R5D83MOMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Joplin LLC Internal Medicine CurrentSince May 7, 2018 Accepting new patients
Hospital Medicine Services of Tennessee PC Internal Medicine CurrentSince May 1, 2019 Accepting new patients
Citizens Memorial Healthcare CurrentSince Nov 20, 2018 Accepting new patients
Citizens Memorial Healthcare Hospitalist CurrentSince Nov 20, 2018 Accepting new patients
Hni Medical Services of Missouri, LLC Internal Medicine CurrentSince Apr 1, 2022 Accepting new patients
Select Specialty Hospital Springfield Inc CurrentSince Apr 9, 2019 Accepting new patients
Select Specialty Hospital Springfield Inc Past Accepting new patients

Locations

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

1432 Southwest Blvd
Jefferson Cty, MO 65109
Phone (573) 632-5560

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

1630 E Primrose St
Springfield, MO 65804
Phone (417) 885-4700

Organizations & group practices 11

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1134604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731369600000",
    "number": "1316923956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 1100",
            "city": "WEST PLAINS",
            "state": "MO",
            "postal_code": "657751100",
            "telephone_number": "417-257-5800",
            "fax_number": "417-257-5999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 N KENTUCKY AVE",
            "city": "WEST PLAINS",
            "state": "MO",
            "postal_code": "657752029",
            "telephone_number": "417-256-9111",
            "fax_number": "417-257-5999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRYDEN",
        "first_name": "JEFFREY",
        "middle_name": "L",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-15",
        "last_updated": "2024-11-12",
        "certification_date": "2024-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "R5D34",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "MO",
            "license": "R5D34",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "125592003",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1316923956",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Plains, MO

Sources for this page

Verify at the official NPI Registry.