Douglas R Bishop

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

2014038385 Issued in MO

Practice address

2865 James Blvd
Poplar Bluff, MO 63901-2803

Phone

(573) 776-1100

Fax

(573) 776-1107

NPI assigned

Nov 14, 2014

Last updated

Nov 14, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southeastern Physician Services PCGroup PAC ID 0042307852, 591 clinicians

Galen Inpatient Physicians PCGroup PAC ID 3678464633, 1,045 clinicians

Sound Physicians of Illinois LLCGroup PAC ID 1557533734, 193 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Barnes-Jewish St Peters Hospital Hospital, Saint Peters, MO, CCN 260191
• SSM St Clare Health Center Hospital, Fenton, MO, CCN 260081
• SSM Health Depaul Hospital St Louis Hospital, Bridgeton, MO, CCN 260104
• Christian Hospital Northeast Hospital, Saint Louis, MO, CCN 260180

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Galen Inpatient Physicians PC.

  • Hospitalist Physician
  • Fenton, MO
  • NPI 1538714688
  Medicare reassignment Care Compare group NPD
• Sound Physicians of Illinois, LLC

  • Hospitalist Physician
  • Bridgeton, MO
  • NPI 1043598865
  Medicare reassignment Care Compare group NPD
• Southeastern Physician Services PC

  • Hospitalist Physician
  • Oak Ridge, TN
  • NPI 1083835441

  MO

  Medicare reassignment Care Compare group NPD
• Bothwell Regional Health Center

  • General Acute Care Hospital
  • Sedalia, MO
  • NPI 1235102690
  Medicare reassignment NPD
• Cogent Healthcare of Missouri, Inc

  • Critical Care Medicine (Internal Medicine) Physician
  • Fenton, MO
  • NPI 1780961599
  Medicare reassignment NPD
• Madison Medical Center Stockhoff Memorial Nursing Home

  • Critical Access Hospital
  • Fredericktown, MO
  • NPI 1720163025
  Medicare reassignment
• Bothwell Regional Health Center

  dba Cole Camp Clinic

  • Rural Health Clinic/Center
  • Cole Camp, MO
  • NPI 1497705313
  NPD
• Bothwell Regional Health Center

  dba Bothwell Physicians Group

  • General Practice Physician
  • Sedalia, MO
  • NPI 1508239781
  NPD
• Galen Inpatient Physicians PC

  • Hospitalist Physician
  • Los Angeles, CA
  • NPI 1205787686
  NPD

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

• Barnes Jewish St Peters Hospital Inc

  dba Barnes-Jewish St Peters Hospital

  • General Acute Care Hospital
  • Saint Peters, MO
  • NPI 1144238908
  Care Compare affiliation
• Christian Hospital Northeast- Northwest

  • General Acute Care Hospital
  • Saint Louis, MO
  • NPI 1639186760
  Care Compare affiliation
• Christian Hospital Northeast-Northwest

  dba Christian Hospital

  • Ambulance
  • Saint Louis, MO
  • NPI 1073769329

  Hospital

  Care Compare affiliation
• SSM Health Care St. Louis

  dba SSM Health DePaul Hospital - St. Louis

  • General Acute Care Hospital
  • Bridgeton, MO
  • NPI 1598835308
  Care Compare affiliation
• SSM Health Care St. Louis

  dba SSM Health St. Clare Hospital - Fenton

  • General Acute Care Hospital
  • Fenton, MO
  • NPI 1851496152
  Care Compare affiliation

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

{
    "created_epoch": "1415923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415923200000",
    "number": "1417353608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 INDUSTRIAL DR",
            "city": "FESTUS",
            "state": "MO",
            "postal_code": "630284133",
            "telephone_number": "636-638-1506",
            "fax_number": "636-638-1507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2865 JAMES BLVD",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639012803",
            "telephone_number": "573-776-1100",
            "fax_number": "573-776-1107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BISHOP",
        "first_name": "DOUGLAS",
        "middle_name": "R",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-11-14",
        "last_updated": "2014-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MO",
            "license": "2014038385",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MO",
            "license": "2014038385",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MO",
            "license": "2009003804",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "APPLYING",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael Billings, O.D.
• Eric Billington, PHD
• Bio-Medical Applications of Missouri, Inc. (Fresenius Medical Care Poplar Bluff Home)
• Bio-Medical Applications of Missouri, Inc. (Fresenius Medical Care - Poplar Bluff West)
• Amanda Bishop, LPN
• Lisa Diane Bishop
• Bizzee Kidz Therapy, LLC
• Black River Ambulatory Surgery Center, LLC
• Black River Community Medical Center (Black River Medical Center)
• Black River Healthcare, Inc.

• Adult Health Nurse Practitioner in Poplar Bluff, MO
• Providers in Poplar Bluff, MO by specialty
• Adult Health Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.