Individual provider Active NPI

Michele L. Neblock, M.D.

  • Family Medicine Physician
  • Troy, MO
National Provider Identifier
1366441495
Registry record updated Mar 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036099585 Issued in IL
Practice address
1175 E Cherry St
Troy, MO 63379-1520
Phone
(636) 528-7722
Fax
(636) 528-7744
NPI assigned
Jul 20, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2010

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 036099585 IL Primary
Family Medicine Physician 207Q00000X 111246 MO

Addresses

Primary practice location

1175 E Cherry St
Troy, MO 63379-1520

Mailing address

1175 E Cherry St
P.O. Box 315
Troy, MO 63379-1520
Phone (636) 528-7722

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100605000062 MO Practitioner - Family Practice 6204832579 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036099585ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hermann Area Hospital District Family Medicine CurrentSince Apr 2, 2018 Accepting new patients
Hermann Area Hospital District CurrentSince Apr 2, 2018 Accepting new patients

Locations

509 W 18th St
Hermann, MO 65041
Phone (573) 486-2045

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/f62890b5-77ff-44bd-a981-0a0981047b35/

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1121817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269475200000",
    "number": "1366441495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1175 E CHERRY ST",
            "address_2": "P.O. BOX 315",
            "city": "TROY",
            "state": "MO",
            "postal_code": "633791520",
            "telephone_number": "636-528-7722",
            "fax_number": "636-528-7744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1175 E CHERRY ST",
            "city": "TROY",
            "state": "MO",
            "postal_code": "633791520",
            "telephone_number": "636-528-7722",
            "fax_number": "636-528-7744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEBLOCK",
        "first_name": "MICHELE",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-20",
        "last_updated": "2010-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036099585",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "111246",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, MO

Sources for this page

Verify at the official NPI Registry.