Individual provider Active NPI

Steven Dale Atwood, M. D.

  • Specialist
  • Springfield, MO
National Provider Identifier
1386643773
Registry record updated Nov 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
R1K19 Issued in MO
Practice address
3525 S National Ave
Ste 206
Springfield, MO 65807-7310
Phone
(417) 269-9200
Fax
(417) 269-9204
NPI assigned
Jul 18, 2005
Last updated
Nov 28, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 28, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X R1K19 MO Primary

Addresses

Primary practice location

3525 S National Ave
Ste 206
Springfield, MO 65807-7310

Mailing address

3525 S National Ave
Ste 206
Springfield, MO 65807-7310
Phone (417) 269-9200

Other identifiers 2

IdentifierTypeStateIssuer
202763058MedicaidMO
18731OtherMOBLUE CROSS BLUE SHIELD OF

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ozarks Medical Center Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1121644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322438400000",
    "number": "1386643773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3525 S NATIONAL AVE",
            "address_2": "STE 206",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658077310",
            "telephone_number": "417-269-9200",
            "fax_number": "417-269-9204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3525 S NATIONAL AVE",
            "address_2": "STE 206",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658077310",
            "telephone_number": "417-269-9200",
            "fax_number": "417-269-9204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATWOOD",
        "first_name": "STEVEN",
        "middle_name": "DALE",
        "credential": "M. D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-18",
        "last_updated": "2011-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MO",
            "license": "R1K19",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "202763058",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF",
            "identifier": "18731",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.