NPIMap

Individual provider Active NPI

Richard Lyle Ogles, MD

  • Diagnostic Radiology Physician
  • Springfield, MO
National Provider Identifier
1336379197
Registry record updated Aug 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
209015682 Issued in MO
Practice address
3850 S National Ave Ste 300
Springfield, MO 65807-5287
Phone
(417) 269-6170
NPI assigned
Jul 15, 2009
Last updated
Aug 19, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 209015682 MO Primary

Addresses

Primary practice location

3850 S National Ave Ste 300
Springfield, MO 65807-5287

Mailing address

1411 E Primrose St Ste C
Springfield, MO 65804-4377
Phone (417) 882-1207

Other identifiers 1

IdentifierTypeStateIssuer
200022835MedicaidMO

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
I20150618001629 MO Practitioner - Diagnostic Radiology 8224349105 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Tennessee, HSC, College of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physicians for Breast Health LLCGroup PAC ID 2062554462, 6 clinicians

Practice addresses (Care Compare)

3850 S National Ave
Suite 300
Springfield, MO 65807-5287
Phone (417) 269-6170

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209015682MOMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians for Breast Health, L.L.C. Diagnostic Radiology CurrentSince Apr 1, 2021 Accepting new patients

Locations

29 NW 1st Ln
Lamar, MO 64759
Phone (417) 681-5266

1411 E Primrose St
Ste C
Springfield, MO 65804
Phone (417) 882-1207

3850 S National Ave
Ste 300
Springfield, MO 65807
Phone (417) 269-5239

Organizations & group practices 1

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": "1247616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660867200000",
    "number": "1336379197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1411 E PRIMROSE ST STE C",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658044377",
            "telephone_number": "417-882-1207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3850 S NATIONAL AVE STE 300",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658075287",
            "telephone_number": "417-269-6170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OGLES",
        "first_name": "RICHARD",
        "middle_name": "LYLE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-15",
        "last_updated": "2022-08-19",
        "certification_date": "2022-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MO",
            "license": "209015682",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200022835",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MO

Sources for this page

Verify at the official NPI Registry.