NPIMap

Individual provider Active NPI

Micheal J Durham, D.O.

  • Family Medicine Physician
  • Lebanon, MO
National Provider Identifier
1326005190
Registry record updated Jul 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2010019729 Issued in MO
Practice address
755 Cowan Dr
Lebanon, MO 65536-4629
Phone
(417) 532-2805
Fax
(417) 532-2848
NPI assigned
Apr 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4291 OK
Family Medicine Physician 207Q00000X 2010019729 MO Primary

Addresses

Primary practice location

755 Cowan Dr
Lebanon, MO 65536-4629

Mailing address

54 Hospital Dr
Osage Beach, MO 65065-3050
Phone (573) 348-8000

Other identifiers 1

IdentifierTypeStateIssuer
1326005190MedicaidMO

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
I20100826000652 MO Practitioner - Family Practice 2860402302 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Oklahoma State University College of Osteopathic Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lake Regional Health SystemGroup PAC ID 9133026776, shared by 16 NPIs, 132 clinicians

Practice addresses (Care Compare)

54 Hospital Dr
Osage Beach, MO 65065-3050

755 Cowan Dr
Lebanon, MO 65536-4629
Phone (417) 532-2805

Hospital & facility affiliations

  • Integrity Home Care + Hospice Home health agency, Springfield, MO, CCN 267576
  • Lake Regional Health System Hospital, Osage Beach, MO, CCN 260186
  • Mercy Hospital Lebanon Hospital, Lebanon, MO, CCN 260059

Merit-based Incentive Payment System (MIPS)

Final score
94.19 of 100Reported as group
Promoting interoperability
100
Improvement activities
40
Cost
75.51

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Regional Health System CurrentSince Sep 1, 2016 Accepting new patients
Lake Regional Health System Family Medicine CurrentSince Sep 1, 2016 Accepting new patients
Lake Regional Health System Current Accepting new patients
Integris Baptist Regional Health Center Past Accepting new patients
Baptist Healthcare of Oklahoma Past Accepting new patients

Locations

226 E US Highway 54
Camdenton, MO 65020
Phone (573) 346-3700

1930 N Business Route 5
Unit 1A
Camdenton, MO 65020
Phone (573) 346-5624

1930 N Business Route 5
Camdenton, MO 65020
Phone (573) 346-5624

304A E 4th St
Eldon, MO 65026
Phone (573) 392-5654

156 Missouri Blvd
Gravois Mills, MO 65037
Phone (573) 374-5263

755 Cowan Dr
Lebanon, MO 65536
Phone (417) 532-2805

54 Hospital Dr
Osage Beach, MO 65065
Phone (573) 280-2772

Interoperability endpoints

  • Direct secure messaging: michealdurham@mhccaremail.com

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 8

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

NPI Registry JSON

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

{
    "created_epoch": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752105600000",
    "number": "1326005190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "54 HOSPITAL DR",
            "city": "OSAGE BEACH",
            "state": "MO",
            "postal_code": "650653050",
            "telephone_number": "573-348-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 COWAN DR",
            "city": "LEBANON",
            "state": "MO",
            "postal_code": "655364629",
            "telephone_number": "417-532-2805",
            "fax_number": "417-532-2848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DURHAM",
        "first_name": "MICHEAL",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-27",
        "last_updated": "2025-07-10",
        "certification_date": "2025-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "4291",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2010019729",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1326005190",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, MO

Sources for this page

Verify at the official NPI Registry.