NPIMap

Individual provider Active NPI

Ian Lester Fawks, DO

  • Family Medicine Physician
  • Springfield, MO
National Provider Identifier
1386640910
Registry record updated Feb 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
115964 Issued in MO
Practice address
3801 S National Ave
Springfield, MO 65807-5210
Phone
(417) 269-7728
Fax
(417) 269-7729
NPI assigned
Jun 28, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 115964 MO Primary

Addresses

Primary practice location

3801 S National Ave
Springfield, MO 65807-5210

Mailing address

PO Box 505673
Saint Louis, MO 63150-5673

Other practice location 1

1000 E Hwy 60
Monett, MO 65708-8258
Phone (000) 000-0000

Other identifiers 2

IdentifierTypeStateIssuer
129355OtherBLUE CROSS
244976403MedicaidMO

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
I20081103000683 MO Practitioner - Family Practice 0840201018 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lester E Cox Medical CentersGroup PAC ID 5799787784, 240 clinicians

Practice addresses (Care Compare)

3801 S National Ave
Springfield, MO 65807-5210
Phone (417) 269-7820

3801 S National Ave
Springfield, MO 65807-6090
Phone (417) 269-7728

Hospital & facility affiliations

  • Cox Medical Centers Hospital, Springfield, MO, CCN 260040

Merit-based Incentive Payment System (MIPS)

Final score
85.78 of 100Reported as group
Quality
74.39
Promoting interoperability
100
Improvement activities
40
Cost
78.21

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
115964MOMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lester E Cox Medical Centers Current Accepting new patients
Lester E Cox Medical Centers Family Medicine CurrentSince Aug 1, 2013 Accepting new patients
Cox-Monett Hospital, Inc. CurrentSince Feb 19, 2025 Accepting new patients
Lester E Cox Medical Centers CurrentSince Aug 1, 2013 Accepting new patients
Cox-Monett Hospital, Inc. Current Accepting new patients
Moberly HBP Medical Group LLC Past Accepting new patients
Lester E Cox Medical Centers Past Accepting new patients

Locations

1000 E US Highway 60
Monett, MO 65708
Phone (417) 354-1269

3801 S National Ave
Ste 1122
Springfield, MO 65807

3801 S National Ave
Fl 5
Springfield, MO 65807

3801 S National Ave
Springfield, MO 65807
Phone (417) 269-4056

Organizations & group practices 7

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 3

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": "1119916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740528000000",
    "number": "1386640910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 505673",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631505673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 S NATIONAL AVE",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658075210",
            "telephone_number": "417-269-7728",
            "fax_number": "417-269-7729"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 E Hwy 60",
            "address_purpose": "LOCATION",
            "city": "Monett",
            "state": "MO",
            "postal_code": "657088258",
            "country_code": "US",
            "telephone_number": "000-000-0000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FAWKS",
        "first_name": "IAN",
        "middle_name": "LESTER",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-28",
        "last_updated": "2025-02-26",
        "certification_date": "2025-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "115964",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "129355",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "244976403",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MO

Sources for this page

Verify at the official NPI Registry.